18.104.22.168 Represent the Board at the National Council of State Boards of Nursing (NCSBN) Delegate Assembly as a voting delegate, certain professional and/or community functions, and regional or national meetings, or shall designate a member or the Executive Director to represent the Board;
22.214.171.124 In the event of a resignation, termination or departure of one of the officers, a replacement shall be elected at the next Board meeting or at a meeting called for that purpose. A quorum of the Board is required.
1.2.1 All members appointed to the Board share the responsibility vested in the Board. The President of the Board shall consider qualifications and educational preparation in delegating certain duties to individual members of the Board.
1.2.4 The members of the Board shall attend all scheduled Board business meetings. If there are extenuating circumstances which prevent a member from attending all or part of a scheduled meeting, the Executive Director should be informed in writing, if time permits, or by telephone, in advance of the meeting.
"Advanced assessment" means the taking by an advanced practice registered nurse (APRN) of the history, physical and psychological assessment of a patient's signs, symptoms, pathophysiologic status and psychosocial variations in the determination of differential diagnoses and treatment.
“Board” means the Delaware Board of Nursing.
"Clinical learning experiences" means the planned, faculty-guided learning experiences that involve direct contact with patients.
"Competence" means the ability of the nurse to integrate knowledge, skills, judgment, and personal attributes to practice safely and ethically in a designated role and setting in accordance with the scope of nursing practice.
"Comprehensive nursing assessment" means collection, analysis and synthesis of data performed by an RN used to establish a health status baseline, plan care and address changes in a patient's condition.
“Conditional Approval” means the status granted to a program that is determined to be deficient in a specified area or areas. When this determination is made by the Board, written notice shall be sent to the program specifying the deficient areas, and the time limit within which the deficiencies are to be corrected. May apply to any program either holding “full” or “initial” approval and may also apply to Delaware Board-approved RN or LPN Refresher Programs.
"Focused nursing assessment" means recognizing patient characteristics by an LPN/VN that may affect the patient's health status, gathering and recording assessment data and demonstrating attentiveness by observing, monitoring, and reporting signs, symptoms, and changes in patient condition in an ongoing manner to the supervising registered nurse or physician.
“Full Approval” means the status granted to a program that meets the requirements of the Law and the Rules and Regulations of the Board. Continuation of full approval is contingent upon annual review of the program and continuing to meet the criteria.
“Initial Approval” means authorization to admit students and enter into contractual agreements for clinical facilities. It is granted only after an application has been submitted, reviewed and a survey visit made by the Board. No students shall be admitted to the program until the institution has received written notification that initial approval has been granted. Failure to comply will delay initial approval.
“National Accrediting Agency for Nursing Education” means a national accrediting agency for nursing education that is recognized by the Council on Postsecondary Accreditation and by the U.S. Department of Education.
“Nursing Education Program” is defined in 24 Del.C. Ch. 19.
"Patient-centered health care plan" means, in collaboration with patient, the identification of desired goals, strategies for meeting goals and processes for promoting, attaining and maintaining optimal patient health outcomes.
“Preceptor” means a nurse, who holds a BSN or higher degree, and a valid license to practice. Clinical preceptors shall have demonstrated competencies in the area of practice to which the student is assigned. Clinical preceptors may be used to accomplish faculty directed clinical learning experiences.
"Supervision" means provision of guidance or oversight by a qualified nurse for the accomplishment of a nursing task or activity with initial direction of the task or activity and periodic inspection of the actual act of accomplishing the task or activity.
2.2 Authority Designated to the Board of Nursing
In accordance with 24 Del.C. Ch. 19, the Board may:
2.2.3 Approve such program to meet the requirements of the Chapter and of the Board; and
2.2.4 Deny or withdraw approval for nursing education programs for failure to meet prescribed curriculum or other standards. (Subsections 1906 (b), (c), (e)).
2.3.2 Provide for the criteria for the development, evaluation and improvement of new and established nursing education programs.
2.3.3 Assure candidates are educationally prepared for licensure and recognition at the appropriate level.
All nursing education programs shall meet these standards:
The purpose and outcomes of the nursing programs shall be consistent with the Nurse Practice Act and Board promulgated administrative rules, regulations and other relevant state statutes.
The purpose and outcomes of the nursing program shall be consistent with generally accepted standards of nursing practice appropriate for graduates of the type of nursing program offered.
The curriculum shall provide diverse didactic and clinical learning experiences consistent with program outcomes.
Professionally, academically and clinically qualified nurse faculty shall be sufficient in number and expertise to accomplish program outcomes and quality improvement. (Section 126.96.36.199 – Faculty Qualifications)
Program information communicated by the nursing program shall be accurate, complete, consistent and readily available.
2.4.1 Required Criteria for Nursing Education Programs – The organization and administration of the nursing education shall be consistent with the law governing the practice of nursing. The nursing education program shall be an integral part of a governing institution with appropriate accreditation. The following minimum criteria serve to support the implementation of the Nursing Education Standards:
188.8.131.52.1 By December 1 of each year, a copy of an annual report of the nursing education program shall be sent to the Board, using the format supplied by the Board. The report will include information from the previous academic year and is required of new programs as well. This is a comprehensive education program self-evaluation and shall include but not be limited to:
184.108.40.206.1.2 Evidence of adequate program resources including fiscal, physical, human, clinical and technical learning resources; and the availability of clinical sites and the viability of those sites to meet the objectives of the program.
220.127.116.11.1 A nursing education program shall maintain a system of records which shall contain all data relating to approval by any agency or body. The data shall include, but not be limited to, course outlines, minutes of faculty and committee meetings, pertinent correspondence, reports of standardized tests and survey reports. Such data shall be available to the Board representatives during the course of a survey or site visit subject to applicable provisions of state and federal law.
18.104.22.168 Student Records
22.214.171.124.1 The school shall maintain a record for each student subject to applicable provisions of law, such records shall be available to Board representatives during the course any survey or site visit.
126.96.36.199.1 Current information about the school shall be published periodically and distributed to students, applicants for admission and to the Board. It should include a general description of the program, philosophy and objectives of the controlling institution and of the nursing programs, admission and graduation requirements, fees, expenses, and financial aid, educational facilities, living accommodations, student activities and services, curriculum plan, course descriptions, process for addressing student complaints and/or grievances and faculty staff roster.
188.8.131.52.2.2 For a baccalaureate degree program, the administrator shall hold an earned doctoral degree in nursing or related field and a master’s degree in nursing from a nationally accredited program. For an associate degree or diploma program, the administrator shall hold a minimum of a master’s degree in nursing from a nationally accredited program.
184.108.40.206.3.3 Education and experience of faculty members (current experience in all specialties must be represented among the faculty and must correspond with the primary teaching responsibilities assigned)
220.127.116.11.6 Faculty assignments shall allow time for class and laboratory preparation, teaching, program evaluation, improvement of teaching methods, guidance of the students, participation in faculty organizations and committees, attendance at professional meetings, and participation in continuing education activities.
18.104.22.168.8 The nursing faculty shall hold a current, active, unencumbered Delaware RN license or compact (multi-state) license and meet requirements in the state where the program is approved and/or accredited.
22.214.171.124.12 Adjunct clinical faculty employed solely to supervise clinical nursing experiences of students shall have a minimum of a baccalaureate degree in nursing with the majority holding a master’s degree in nursing or actively enrolled in a master’s degree in nursing program.
126.96.36.199.14 Clinical preceptors shall have demonstrated competencies related to the area of assigned clinical teaching responsibilities and will serve as a role model and educator for the student. Clinical preceptors may be used to enhance faculty-directed clinical learning experiences. Clinical preceptors should be licensed as a nurse at or above the level for which the student is preparing.
188.8.131.52.15.4 Minutes, guided by an agenda, of faculty and committee meetings and will include: conclusions made following discussions, recommendations and actions as well as timeline for evaluation and follow-up.
184.108.40.206.15.7 Written rules shall govern the activities of the nursing practice/education (advisory) committee(s) and minutes of the meetings shall be on file in the administrative office of the program.
220.127.116.11.1 Students shall be provided the opportunity to acquire and demonstrate the knowledge, skills and abilities for safe and effective nursing practice, in theory and clinical experience with faculty oversight.
18.104.22.168.6.4 Schools granting advanced standing after admission via challenge examinations, College Level Examination Program, teacher made tests or any other method shall have written criteria for granting course credit. Course credits attained through one of these mechanisms or transferred in from another institution shall not represent more than fifty (50) percent of the credits required for graduation.
22.214.171.124.6.6 All candidates in a program that requires applicants to be registered nurses must be licensed in Delaware or hold a current, valid compact (multi-state) license if any clinical experiences occur in the State.
126.96.36.199.1 The curriculum of the nursing education program shall enable the student to develop the nursing knowledge, skills and abilities necessary for the level, scope and standards of competent nursing practice expected at the level of licensure. The curriculum will be revised as necessary to maintain a program that reflects advances in health care and its delivery.
188.8.131.52.2 LPN and RN programs shall provide for concurrent or correlated theory and clinical practice in the physical and/or mental health care of individuals of all ages the nursing care of mothers and newborns, children, adults, the aged, individuals with mental health problems, and individuals in diverse settings, not necessarily in separate courses.
184.108.40.206.3 Clinical experiences shall include preventive aspects of illness, nursing care of persons with acute and chronic illnesses and rehabilitative care. Opportunities shall be provided for the student to participate in patient teaching in a variety of settings with individuals, families and groups.
220.127.116.11.4 A minimum of 200 hours of clinical experience is required for LPN students and a minimum of 400 hours of clinical experience is required for RN students. Simulation – high fidelity and/or standardized patient – clinical experiences may be used for a portion of the clinical experience requirements. LPN clinical does not equate to RN clinical and may not be substituted or included for RN clinical in an educational program nor as RN clinical practice to meet the practice hour requirement for relicensure.
18.104.22.168.5 The curriculum, as defined by nursing education, professional and practice standards, shall include:
22.214.171.124.5.1 Experiences that promote the development and subsequent demonstration of evidence-based clinical judgment, skill in clinical management, and the professional commitment to collaborate in continuously improving the quality and safety of the healthcare system for patients.
126.96.36.199.5.3.3 Didactic content and supervised clinical experience in the prevention of illness and the promotion, restoration and maintenance of health in patients across the lifespan and from diverse cultural, ethnic, social and economic backgrounds. Patient experiences will occur in a variety of clinical settings and will include:
188.8.131.52.184.108.40.206 Implementing evidence-based practice to integrate best research with clinical expertise and patient values for optimal care, including skills to identify and apply best practices to nursing care.
220.127.116.11.5.5 Participating in quality improvement processes to monitor patient care outcomes, identify possibility of hazards and errors, and collaborate in the development and testing of changes that improve the quality and safety of health care systems.
18.104.22.168.6 Faculty supervised clinical practice shall include development of skills in direct patient care; making clinical judgments; care and management of both individuals and groups of patients across the lifespan; and delegation to and supervision of, as appropriate to level of education, other health care providers.
22.214.171.124.6.3 Measurement of students' competencies shall focus on the students' demonstration of care management and decision making skills when providing patient care in a variety of clinical situations and care settings.
126.96.36.199.7 Delivery of instruction by distance education methods must be consistent with the program curriculum plan and enable students to meet the goals, competencies and outcomes of the educational program and standards of the BON.
188.8.131.52.1 Evaluation as a basis for curriculum revision and change in practices is a continuous process and an inherent responsibility of the faculty. The degree to which the faculty accomplishes its objectives shall be determined through evaluation of curriculum content, teaching methodologies, clinical and other learning experiences, student progress, success of graduates on the licensing examination, promotion, retention and degree of nursing competence of the graduate.
184.108.40.206 Education Facilities
220.127.116.11.3.1 Learning resources must be recent, pertinent and sufficient to meet the learning needs of students and faculty.
18.104.22.168.3.1.1 Provisions shall be made for regular additions to and deletions from the resource collection.
22.214.171.124.3.1.2 Learning facilities and policies shall be conducive to effective use.
126.96.36.199.4.1.1 Clinical facilities shall be selected by the faculty to provide learning experiences essential to achieve the stated purposes of the program and the stated objectives for each clinical course. They may include, but are not limited to:
188.8.131.52.184.108.40.206 Other community based opportunities such as home health, hospices, health maintenance organizations, day care centers, schools/school systems, senior centers and correctional facilities.
220.127.116.11.4.1.3 Hospital facilities shall be accredited by the Joint Commission or the American Osteopathic Association. Other facilities such as specialized hospitals, long term and extended care facilities and community health agencies shall be licensed or accredited by the appropriate approving authority.
18.104.22.168.4.1.4 Facilities used for clinical experience shall be approved by the Board prior to the assignment of students. Approval shall be based on information provided by the school on forms furnished by the Board. A visit by Board representatives to the clinical site may be scheduled.
22.214.171.124.4.1.5 Use of clinical facilities in another state or jurisdiction requires written notification to that jurisdiction’s Board of Nursing. Likewise, out of state schools requesting use of clinical facilities in Delaware will notify the Board prior to utilization.
126.96.36.199.188.8.131.52 Out of state programs must submit, prior to utilization of a Delaware clinical facility: proof of program approval by a respective State Board of Nursing and/or accreditation of the program by a nationally recognized accrediting body; copies of written agreements with every clinical agency being utilized; program requirements for clinical faculty and/or preceptors, if used; name of faculty/preceptor and site(s) where assigned; copy of current Delaware or compact (multi-state) licensure for faculty/preceptor.
184.108.40.206.220.127.116.11 Ensure that the faculty is ultimately responsible for the students’ learning experiences.
2.4.2 Purpose of New Nursing Education Program Approval. The State requires that new nursing education programs be approved in order to: promote the safe practice of nursing by implementing standards for individuals seeking licensure as registered nurses and licensed practical nurses; grant legal recognition to nursing education programs that the board determines have met the standards; assure graduates that they meet the education and legal requirements for the level of licensure for which they are preparing and to facilitate their endorsement to other states and countries; assure continuous evaluation and improvement of nursing education programs; provide the public and prospective students with a list of nursing programs that meets the standards established by the Board.
2.5 Procedure for Establishing (New) Nursing Education Programs
18.104.22.168 An administrative officer of the institution shall complete the appropriate application form supplied by the Board and forward both one hardcopy and an electronic file copy in a format specified by the Board to the Executive Director of the Board prior to planned enrollment of students.
22.214.171.124 The proposed program shall provide the following information to the Board at the time of application:
126.96.36.199 The Board shall review the application and determine whether it is complete and meets the criteria established in the current application guidelines to move to Phase II. No applicant program may proceed into Phase II until the Board has determined that the applicant program has met all the requirements of Phase I.
188.8.131.52 The institution shall notify the Board of the appointment of a qualified nurse as director of the program at least five (5) months in advance of the anticipated enrollment of students in nursing courses.
184.108.40.206 The institution shall appoint other qualified nurse faculty members in advance of enrollment of students in nurse courses to participate in determining the theoretical framework and in developing the curriculum plan and course content.
220.127.116.11 The program shall be developed according to criteria in accordance with 2.4 of these Regulations. An applicant program must demonstrate compliance with Rule 2.4 before it may proceed into Phase III.
18.104.22.168 The Board shall review information from the Phase I and Phase II application forms and materials and conduct a site visit. At least one of the visitors shall be the nurse educator member of the Board.
22.214.171.124.1 Alternatively, the institution desiring to establish a nursing education program may elect to have a site visit made by a Board member(s) and a nursing education consultant, the latter with special expertise in the same type of nursing education as the proposed program. The consultant shall be from a list of qualified persons approved by the Board. Costs associated with the visit of the consultant shall be borne by the nursing education program requesting the same.
126.96.36.199 The Board shall review the application and supporting information at the regularly scheduled meeting and determine if the program is prepared to admit students. If it is so determined, initial approval will be granted.
188.8.131.52 When the Board determines that an applicant program has met the requirements of Phase I and Phase II, the board shall grant the program initial approval and the applicant program may begin to admit students.
184.108.40.206 Following initial approval, the director of the program shall submit a copy of a progress report to the Board at least every six months (December and June). This shall be a general report of progress to date to include the number of students enrolled, attrition rate, faculty credentials, curriculum design, and use of clinical facilities and shall address status and progress on any deficiencies noted as a result of any site visit(s) and/or documentation previously submitted to the Board resulting in any requirements placed on the program by the Board. After the admission of students, these reports shall continue to be submitted at six month intervals until discontinued by the Board.
220.127.116.11.2 The Board will complete a program site visit concurrent with graduation of the first class or their eligibility for NCLEX and prepare a site visit report that verifies the degree to which the program is in compliance with the Board of Education standards found in 2.4 of this Section.
18.104.22.168 The Board’s decision regarding approval status shall be sent in writing to the appropriate administrative officers and to the director of the nursing education program. New programs will have five years from the first graduating class to obtain national accreditation.
22.214.171.124.1 If the Board determines that any approved nursing education program is not maintaining the standards required by this chapter the Board shall give written notice thereof, specifying the deficiency and the time within which the same shall be corrected to the program.
126.96.36.199.3 Such nursing education program may request, upon written application, a hearing on the Board’s proposal to withdraw.
188.8.131.52 Each nursing education program shall be accredited by a Board-approved national accrediting agency for nursing education and must submit a copy of the self-study document and the letter of notification of accreditation status following the accreditation/re-accreditation visit. This is contingent on the program remaining accredited and sharing copies of all correspondence related to compliance with the national accrediting agency’s recommendations. Extraneous material will be disseminated to Board Members at the discretion of the Executive Director in consultation with the Board President.
184.108.40.206 Each nursing education program that does not have Board approved national accreditation will obtain accreditation by December 30, 2016.
220.127.116.11 Interim (site) visits may be made at any time either by request or as deemed necessary by the Board, with advance notice. At least one of the visitors shall be a nurse educator who has curriculum expertise at the level of the program being reviewed.
18.104.22.168 The Board shall monitor and analyze various sources of information regarding program performance, including but not limited to: Periodic site visits and or reports; accreditation visits and reports; results of ongoing program evaluations; other sources of information regarding achievement of program outcomes such as student retention and attrition, faculty turnover, complaints regarding program, and trend data regarding NCLEX performance.
22.214.171.124 The Practice and Education Committee of the Board shall review the annual and self-evaluation reports of the programs. They will compile a summary with recommendations to report to the Board of Nursing.
126.96.36.199 Following review of the reports from the programs, written notification of the action taken at the regularly scheduled board meeting, including any recommendations, shall be sent to the appropriate administrative officers of the school. This will include notification of either continuing full approval or conditional approval (probation). This could include notification of the Board’s intention to conduct a site visit.
188.8.131.52 For any site visit, the Board President shall designate the Board members who are to make the site visits and the chair person of the site visit team. At least one member of each team shall be a nurse educator who has curriculum expertise at the level of the program being reviewed.
184.108.40.206 The site visit may be made by a Board member(s) and an optional nursing education consultant, the latter with special expertise at the same level of nursing education as the program. The consultant shall be selected from a list of qualified persons submitted by the nursing program and approved by the Board. Costs associated with the hiring of the consultant shall be borne by the program.
220.127.116.11.4 Others as deemed appropriate by the school or the Board.
18.104.22.168.5.2 Course Materials
22.214.171.124.5.4 Other materials as specified by the site visit team
126.96.36.199.5 Failure to admit and retain students and/or hire and promote faculty and other personnel without discrimination as to age, race, religion, sex, sexual preference, national origin, or disability.
188.8.131.52 Upon written notification of conditional approval/probation, the program director shall submit an action plan no less than two (2) weeks preceding the Board meeting designated in the notification.
184.108.40.206.2 The action plan will be presented by the school’s program director at a regularly scheduled meeting of the Board. The program director will receive notification of the date for the presentation in writing.
220.127.116.11.3 The Board may approve the plan as submitted, recommend revisions, or reject the plan. If revisions are required or the plan is rejected, the revised or re-written plan shall be submitted within thirty (30) calendar days of the written notification of the Board’s decision. Additional presentations before the Board may be required.
18.104.22.168.4 Program progress reports during the term of conditional approval shall be submitted as specified by the Board and are in addition to any other reporting requirement specified in this Section.
22.214.171.124.5 Prior to the expiration of the conditional approval period, the program director will meet with the Board during a regularly scheduled Board meeting to review the status of the plan relative to remediation of the deficiency(ies).
126.96.36.199.6.1 If satisfactory remediation has not occurred in the stated timeline, the program director shall submit a written explanation and revised action plan with projected timeline(s). The Board may approve the plan as submitted, or with revision, or may reject the plan and move to propose the withdrawal of the program’s approval.
188.8.131.52 The Board may withdraw full approval if it determines that a nursing education program fails substantially to meet the standards for nursing education and fails to correct the identified deficiencies within the time specified.
184.108.40.206.5 Notify the Board in writing as to the location of records and where requests for records may be sent.
220.127.116.11.2.1 Online and distance learning programs must provide the same types of resources and students must be taught by qualified faculty, both in didactic and clinical experiences as defined in this Section.
A nursing refresher course is required for Registered and Licensed Practical Nurses who are presently ineligible for endorsement or reinstatement of licensure because they fail to satisfy the active employment requirement of a minimum of 1000 practice hours in the past five years or 400 nursing practice hours in the past two years.
3.2.1 In accordance with the Nurse Practice Act, the design of the course for the Registered and the Licensed Practical Nurse shall incorporate evidence based practice and adult teaching/learning methods appropriate to meet program outcomes.
3.2.5 Each course shall include sufficient theory and supervised clinical practice to meet the course objectives.
3.4.2 The faculty and preceptors shall be Registered Nurses licensed in Delaware or a compact state with a minimum of a Bachelor’s of Science in Nursing degree or have completed all requirements for a BSN in an RN-to-MSN Program.
3.6.1 Refresher courses offered to meet requirements for Registered and Licensed Practical Nurse licensure, renewal, endorsement, reinstatement or reactivation shall be approved by the Board and follow the criteria in Section 2.0-Nursing Education Programs.
18.104.22.168 The course director, faculty and preceptor(s) must submit their curriculum vitae to the Board and meet all requirements as identified in Section 2.0.
3.6.4 Approval shall be considered after the program has been reviewed and has met the standards of the Board. Written notification of the action taken at a regularly scheduled board meeting, including any recommendations, shall be sent to the director of the course.
3.6.6 The entity offering the course shall submit a copy of an Annual Report every year prior to December 1 using a format supplied by the board.
4.1.1 A supervised practice plan (SPP) is available to provide opportunities for a nurse who is presently ineligible for endorsement, reinstatement, or renewal of licensure because the nurse fails to satisfy the 1000 practice hours in the past five years or a minimum of 400 nursing practice hours in the past two years. The SPP only applies if a Delaware Board of Nursing approved refresher course is not available within a reasonable distance or time.
4.2.2 The nurse applicant must contact potential healthcare facilities to obtain approval to utilize a supervised practice plan to obtain the practice hours required. A copy of the SPP clinical skills checklist must be presented to the Chief Nurse Executive of the healthcare facility.
4.2.3 Upon agreeing with an applicant to provide a period of supervised practice for the assurance of minimal competency, the Chief Nurse Executive of the healthcare facility shall verify this agreement in writing by submitting a letter to the Board. The letter should include a statement that the Chief Nurse Executive has reviewed the SPP clinical skills checklist and that the healthcare facility is able to provide the opportunities to demonstrate completion of the skills on the checklist.
4.2.4 Upon receipt of the supervised practice agreement letter, a temporary permit to practice will be issued by the Board to the nurse for presentation to the health care facility. The temporary permit must remain active during the supervised practice period, and it is the applicant's responsibility to renew the temporary permit if it will expire prior to completion of the 240 hours.
4.2.5 The Chief Nurse Executive shall designate a Registered Nurse to provide the supervised clinical nursing practice of no less than 240 hours. The Chief Nurse Executive is accountable for the quality of the supervised experience and the accurate assessment of the competence of the nurse applicant.
4.2.6 Upon completion of the required hours, the Chief Nurse Executive shall submit a completed SPP clinical skills checklist confirming satisfactory completion of the skills and a recommendation regarding the licensure reinstatement, endorsement, or renewal of the nurse applicant.
22.214.171.124 If denied licensure, the applicant will be notified of his or her right to a hearing for reconsideration before the Board of Nursing.
"Core Curriculum" means the educational course of study developed and approved by the Board of Nursing.
"Eligible Programs" means those programs specified under Title 24, Chapter 19 that may utilize LLAM.
"LLAM Trained UAP" means unlicensed assistive personnel who have completed a Board of Nursing approved Limited Lay Administration of Medications curriculum.
"Medication Error" means engaging in any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the UAP.
"Module" means a Board of Nursing approved educational training unit that is eligible program specific and used in addition to the core curriculum.5.2 LLAM Training.
5.2.1 Eligible programs utilizing LLAM must ensure all unlicensed assistive personnel have completed a core curriculum given by a qualified instructor before giving a prescribed medication to a client, patient, resident, or student. Eligible program specific modules may be required by the program. Both the core curriculum and any module must be completed by all unlicensed assistive personnel as approved with no deviations.
5.2.2 Eligible programs must keep a current list of all LLAM Trained UAPs, including supporting documentation. Eligible programs must also maintain a current list of all qualified instructors. The list of qualified instructors shall be submitted annually to the Board on or before August 1.
5.2.3 Unlicensed assistive personnel who complete a core curriculum and any eligible program specific module, obtain at least an 85% on the written examination, and successfully demonstrate medication administration, will be provided a completion letter, indicating the recipient is a LLAM Trained UAP. No certificates will be issued.
126.96.36.199 Presentation of at least one component of the core curriculum and any eligible program specific module to be taught with observation by a qualified instructor. Documentation of observation must be provided to the eligible program.
5.3.2 Qualified instructors must present a minimum of one core curricula and eligible program specific module per year. If an instructor fails to present in a single year, that instructor must again complete the core curriculum and any eligible program specific module before s/he will be deemed a qualified instructor.
5.3.3 All instructors of courses related to "Assistance with Self-Administration of Medications" approved by the Board as of July 1, 2015 will qualify as LLAM instructors pursuant to regulation 5.3 without being required to satisfy regulations 188.8.131.52-184.108.40.206.
5.4.2 LLAM trained UAPs are required to renew their status annually by successfully demonstrating competency in the LLAM process with no errors and by achieving a minimum score of 85% on the annual review exam. A letter of completion will be issued after successful renewal of competencies each year.
6.1.1 The Board declares that the National Council Licensure Examination-RN (NCLEX-RN) and the National Council Licensure Examination-PN (NCLEX-PN) are the required examinations for licensure in Delaware. The Board of Nursing has the authority to review the content and validity of examinations.
6.1.5 To be eligible to take the examination for licensure for practical nursing, the applicant must be a graduate of a Board approved program for practical nursing. A graduate of a program for professional nursing will be denied permission to take the examination for licensure as a practical nurse.
6.1.8 In addition, the candidate shall file a signed official school transcript indicating the date of graduation or date degree was conferred. If this is not possible, a certifying letter from the director indicating the candidate had completed the program will be accepted until an official transcript is available.
6.2.2 The temporary permit is a limited license authorizing professional or practical nursing practice only at the institution employing the graduate, and only under supervision and pending the results of the examination.
6.2.3 Any graduate who has completed the requirements of a state board of nursing approved program of professional or practical nursing and who has filed for licensure by examination in Delaware may be employed in professional or practical nursing, working under the direct supervision of a Registered Nurse pending results of the licensing examination.
6.2.5 In order to practice nursing in Delaware with a temporary permit, a recent graduate of a state board of nursing approved program of nursing in another state must file an application for licensure before beginning to practice. If the graduate has taken, or is scheduled to take, the NCLEX Examination in the state in which the program is located, the applicant shall file an application for licensure by endorsement in Delaware.
6.2.7 If extenuating circumstances exist, the candidate may apply to the Board for reissuance of a temporary permit. If the reason is acceptable, the permit may be reissued. (Refer to Section 6.7, Temporary Permits)
6.3.1 Notification occurs for the successful candidate in the following order: the candidate and director of the school program, and for the unsuccessful candidate: the candidate, employer and the director of the school program.
6.3.4 Candidates for licensure who fail the National Council Licensure Examination may not be employed as a graduate nurse or a graduate practical nurse, are not permitted to practice nursing as defined in the Law, and must return the temporary permit upon receipt of the failure notification. The applicant shall retake the examination within one year from the date of the initial examination.
6.3.5 After one year, the applicant must petition the Board for specific authorization to test/retest. Such petitions may be granted by the Board upon a showing of good cause to allow for further examination. There is a non-refundable fee for each re-examination request. Any candidate who graduates from an approved nursing education program may retake NCLEX up to 8 times per year at 45 day intervals within a one year period from graduation and not thereafter without petitioning the Board for specific authorization to retest after the one year period for a total of five years.
6.3.6 An applicant who petitions to retake NCLEX after the two year period must successfully complete or have completed an examination review course within the six months immediately prior to a petition to retake the examination.
220.127.116.11 Must submit a certificate issued by the Commission on Graduates of Foreign Nursing Schools or other Board approved agency as evidence of the educational requirements of a curriculum for the preparation of professional nurses which is equivalent to the approved professional schools in Delaware;
18.104.22.168 Must, in instances when completion of a four-year high school course of study or its equivalent cannot be verified, take the high school equivalence examination given by a State Department of Education;
22.214.171.124 Must submit evidence that the program from which applicant is a graduate meets the approved standards adopted by the Board (24 Del.C. §§1910, 1914) and Rules and Regulations: 2.4. (If the program does not include the areas specified in the above curricula, the deficiencies must be made up before the applicant is eligible to take NCLEX);
126.96.36.199 Effective July 1, 1982, professional nurse applicants must have passed the NCLEX examination (with a minimum standard score of 1600) and practical nurse applicants must have passed the NCLEX examination (with a minimum standard score of 350) within four examination opportunities, within a period of two years or original notification of failure.
188.8.131.52 May be issued a temporary permit and may be employed in professional or practical nursing if the applicant has met all of the Board’s prerequisites for taking the NCLEX in Delaware and is scheduled to do so;
6.4.2 RN applicants who meet the requirements listed in 6.4.1 are eligible to take NCLEX-RN. LPN applicants who meet the requirements listed in 6.4.1 are eligible to take the NLCEX-PN. Applicants will be issued a license upon successful completion of the respective NCLEX.
6.4.4 Canadian applicants writing the Canadian Nurses’ Association Testing Service (CNATS) Examination, first administered August 1980, are eligible for licensure by endorsement with a passing score of 400. (September 15, 1981)
6.4.5 Canadian applicants writing the Canadian Nurses’ Association Testing Service (CNATS) Examination after that examination became graded on a pass or fail basis are not eligible for licensure by endorsement and must pass the NCLEX. (June 8, 1996)
6.4.6 Applicants graduating from programs outside of this state which, in the opinion of the Board at the time the application is filed with the Division of Professional Regulation, are equivalent to the minimum requirements of the Board for full approval status established by these regulations, are eligible to take the NCLEX.
184.108.40.206.1 the applicant’s immediate past employer(s) in the past six months. Such reference(s) should be given by the nursing employer, or if the immediate past employer is not a nursing professional, by the applicant’s immediate supervisor (e.g. physician, director, manager). In the case of someone engaged in solo practice or who is self-employed, the reference shall be provided by at least one professional colleague with whom the individual has most recently worked for at least six months in the past five years.
220.127.116.11.2 in the event of no previous nursing employer, the Director of the applicant’s approved nursing education program within two years of graduation. Any unsatisfactory reference shall be brought to the attention of the Board for review.
18.104.22.168 If the applicant has not been employed in nursing a minimum of 1000 hours in the past five years or a minimum of 400 hours of nursing practice within the previous two years, the applicant must give evidence of satisfactory completion of an approved refresher program within a two-year period before licensure by endorsement will be granted. In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional/practical nursing.
22.214.171.124 Submit a completed report on a form provided by the Board office, listing and attesting to the completion of all continuing education requirements for the two years immediately preceding application, unless submitting a refresher course completion certificate.
126.96.36.199 The Board may issue a license to practice professional nursing as a Registered Nurse by endorsement, without a written examination, to an applicant who has been duly licensed as a Registered Nurse under the laws of another state, territory, or foreign country if, in the opinion of the Board, the applicant meets the qualifications for licensure in this state.
188.8.131.52 As of 1950 and thereafter, the State Board Test Pool Examination for professional nursing is the licensing examination authorized for use by all boards of nursing in jurisdictions in the United States. (In July 1982, the examination was re-titled National Council Licensure Examination-RN (NCLEX-RN). Prior to this date, examinations constructed by state boards of nursing are acceptable, providing such examinations include all of the required clinical areas: medicine, surgery, obstetrics-gynecology, pediatrics, psychiatry). Until 1953, the passing score required for each of the tests was 70%.
184.108.40.206 Those applicants graduating as of 1953 and thereafter are required to show evidence of clinical experience in medical nursing, surgical nursing, psychiatric nursing, nursing of children, and obstetrical nursing.
220.127.116.11 Effective October 1, 1963, waiver or equivalency licensure is not acceptable in Delaware. The Board may issue a license to practice nursing as a Licensed Practical Nurse, without a written examination, to an applicant who has been licensed as a Practical Nurse or a person entitled to perform similar services under a different title under the laws of any state, territory or foreign country if, in the opinion of the Board, the applicant has the qualifications and demonstrates convincing evidence that the applicant’s education, training, experience and conduct have been sufficient as required for the licensing of practical nurses.
18.104.22.168 In order to practice nursing in Delaware with or without financial compensation, Registered Nurses or Licensed Practical Nurses who are duly licensed under any provision of 24 Del.C. Ch. 19 shall renew their licenses biennially, on dates established by the Division of Professional Regulation. In the event that applicant for renewal or reinstatement of licensure has not been actively employed/practicing in professional or practical nursing in the past five years, the applicant will be required to give evidence of satisfactory completion of a board-approved professional or practical nursing refresher program within a two-year period prior to the application for renewal before licensure will be granted, In the event no refresher course is available the Board may consider alternate methods of evaluating current knowledge in professional or practical nursing.
22.214.171.124 The applicant shall indicate nursing employment within the past five years before the renewal application will be processed. A minimum of 1000 hours of nursing practice within the past five years or a minimum of four hundred hours of nursing practice within the past two years is required for licensure by renewal or reinstatement. Verification of completion of the practice hours will occur for a minimum of 3% of the total number of licensees with notice of the audit within six months following the renewal of licensure. See 9.0, for Mandatory Continuing Education requirements.
126.96.36.199.1 Upon receipt of such notice, the licensee must submit verification of compliance for the period being audited/verified. Verification will be done on a form supplied by the Board office that includes employer’s name, title, address, telephone number, job title, and dates of employment.
188.8.131.52 Renewal application, along with the required non-refundable fee, shall be completed online by midnight of the last day of the renewal period, or a penalty fee will be assessed.
184.108.40.206 A license may be renewed up to sixty-days past the license’s expiration date, by submitting the penalty fee and proof of completion of continuing education requirements. The license is considered lapsed and the nurse is not permitted to work until the license is renewed. Licensees who fail to renew during the renewal period or during the 60 day late renewal period must apply for reinstatement.
220.127.116.11 Reinstatement of a lapsed license is required after the expiration of the late renewal period. All applicants shall have a minimum of 1000 hours of nursing practice within the previous five years or a minimum of four hundred hours of nursing practice within the past two years before licensure by reinstatement will be granted. The practice of nursing can be with or without financial compensation. In the event the applicant has not been actively employed in nursing as described above, the applicant will be required to give evidence of satisfactory completion of a refresher program with an approved agency within two years prior to reinstatement. In the event no refresher course is available, the Board may consider alternate methods of evaluating current knowledge in professional or practical nursing defined in Section 4.0.
18.104.22.168 The applicant shall file a notarized application for reinstatement of licensure. The application shall be accompanied by a satisfactory reference from a current or previous employer, required continuing education documents, a renewal fee and penalty fee.
6.6.3 It is unprofessional conduct and a violation of Delaware Law to practice without a license. The Board may refuse a license or refuse to renew a license of a professional nurse or a practical nurse who practices without a current license.
22.214.171.124 Hearings for consideration of licensure reinstatement may be held for those applicants who file for reinstatements more than 60 days after the renewal period and who have been practicing nursing without a current license, or who have submitted an unsatisfactory explanation for failure to renew.
126.96.36.199 A notice of hearing shall be sent to the Registered Nurse or Licensed Practical Nurse. The hearing shall be conducted in accordance with the Administrative Procedures Act and the Nurse Practice Act.
188.8.131.52 The Board shall make determination for reinstatement of licensure or shall determine that the Registered Nurse or Licensed Practical Nurse shall be subject to the penalties provided for violations of the Nurse Practice Act.
6.7.2 Nurses who produce current evidence of licensure to practice nursing in another state and who have applied for endorsement may be issued a temporary permit to practice nursing for a maximum of 90 days, if they have been employed in nursing a minimum of 1000 hours in the past five years or a minimum of four hundred hours of nursing practice within the past two years.
6.7.3 A temporary permit to practice nursing for a maximum of 90 days may be issued to persons who have requested reinstatement of their licensure, if they have been employed in nursing a minimum of 1000 hours in the past five years or a minimum of four hundred hours of nursing practice in the past two years.
184.108.40.206 Have been employed in nursing a minimum of 1000 hours in the past five years or a minimum of four hundred hours in the past two years, if applying for reinstatement or endorsement, with current evidence of licensure from another state.
6.7.5 Upon completion of all requirements, a temporary permit will be issued for no longer than 90 days with subsequent renewal periods of 60 and 30 days sequentially. Temporary Permits issued to a graduate nurse or graduate practical nurse are limited per 6.3.4 of these Rules.
6.8.1 A person previously licensed by the Board and not engaged in the practice of nursing in the state of Delaware, but desiring to maintain the right to use the title Registered Nurse or Licensed Practical Nurse, may apply and be granted inactive status by the Board in accordance with these regulations.
6.8.2 A nurse desiring inactive status shall send a written notice to the Board with fee. Upon receipt of notice and fee the Board shall place the name of the person on an inactive status list and shall issue a certificate. The person shall not practice nursing in this state.
6.8.5 A notice to renew inactive status shall be sent to all persons in inactive status at renewal time. Renewal shall be completed by online application and payment of the renewal fee. An inactive license not renewed shall become lapsed and is eligible for reinstatement.
6.8.7 In the event the applicant has not been actively practicing nursing within the previous five years, the applicant will be required to give evidence of satisfactory completion of a refresher program with an approved agency within two years prior to reactivation, or participate in an alternate Board approved method of evaluating current knowledge in professional or practical nursing. All applicants shall have a minimum of 1000 hours of nursing within the previous five years or a minimum of four hundred hours of nursing practice within the previous two years. See 9.0 for Mandatory Continuing Education requirements.
6.9.1 Licensees who legally change their names and wish to change the name on the license, shall provide notarized copies of evidence, such as marriage licenses or court actions. The maiden name will be retained on the license.
6.9.2 Notice of change of address shall be submitted online within 30 days of the change. All notices from the Board will be sent to the last address provided by the licensee or applicant to the Board.
220.127.116.11 The Executive Director shall request each employer or employing agency to submit to the Board by April 15 a list of all nurses employed with a nursing license from another compact state. The list shall include the following information:
Nursing practice encompasses several levels of accountability in order to ensure safe, competent practice. At the foundation of accountability are standards of nursing practice developed by general and specialty nursing professional organizations. A second level of accountability is provided by statutes, rules and regulations promulgated by individual states, based upon each state’s nurse practice act which defines nursing practice. Nurses are also accountable to the institution or agency where they are employed through institutional policies and procedures. A final level of accountability resides with nurses’ self-determination of those aspects of practice they believe themselves competent to perform.
“Standards of Nursing Practice” are those standards adopted by the Board that interpret the legal definitions of nursing, as well as provide criteria against which violations of the law can be determined. Such standards shall not be assumed the only evidence in civil malpractice litigation, nor shall they be given a different weight than any other evidence
“Nursing Process” includes assessment, diagnosis, outcome identification, planning, implementation and evaluation.
The purpose of standards is to establish minimal acceptable levels of safe practice for the Registered and Licensed Practical Nurse, and to serve as a guide for the Board to evaluate safe and effective nursing practice.
7.3 Standards of Practice, Competencies and Responsibilities for the Registered and Licensed Practical Nurse
18.104.22.168 Function as a member of the health team through interdisciplinary and/or interagency consultation and collaboration to provide optimal care, seeking guidance, instruction and supervision as necessary.
22.214.171.124 Perform waived and moderately complex laboratory point of care testing after appropriate education, including annual competency demonstration and quality control measures for equipment, which are completed and documented.
126.96.36.199 Nurses who perform any special procedures should possess specialized knowledge and competent technical skill in the performance of the procedure, be knowledgeable of the potential complications and adverse reactions which may result from the performance of the procedure, possess the knowledge and skill to recognize adverse reactions, and take appropriate actions.
7.4 Standards related to the Registered Nurse.
7.4.1 The Registered Nurse shall conduct and document nursing assessments in accordance with the nursing process. The registered nurse shall assess the health status of individuals and groups by:
188.8.131.52 Collecting objective and subjective data from observations, examinations, interviews, in person or by electronic communication and written records in an accurate and timely manner. The data include but are not limited to:
184.108.40.206.1 Biophysical and emotional status and observed changes;
220.127.116.11.2 Growth and development;
18.104.22.168.3 Ethno-cultural, spiritual, socio-economic and ecological background;
22.214.171.124.4 Family health history;
126.96.36.199.5 Information collected by other health team members;
188.8.131.52.6 Ability to perform activities of daily living;
184.108.40.206.7 Consideration of client’s health goals;
220.127.116.11.8 Client knowledge and perception about health status and potential, or maintaining health status;
18.104.22.168.9 Available and accessible human and material resources;
22.214.171.124.10 Patterns of coping and interaction.
126.96.36.199 Sorting, selecting, reporting, and recording the data.
188.8.131.52 Analyzing data.
184.108.40.206 Validating, refining and modifying the data by using available resources including interactions with the client, family, significant others, and health team members.
220.127.116.11 Evaluating data.
7.4.2 Registered Nurses shall establish and document nursing diagnoses that serve as the basis for the strategy of care.
7.4.3 Registered Nurses shall develop strategies of care based on the nursing process. This includes, but is not limited to:
18.104.22.168 Prescribing nursing intervention(s).
22.214.171.124 Initiating nursing interventions through giving, assisting and/or delegating care.
126.96.36.199 Identifying priorities in the plan of care.
188.8.131.52 Setting realistic and measurable goals for implementation.
184.108.40.206 Identifying measures to maintain comfort, to support human functions and responses, to maintain an environment conducive to well being, and to provide health teaching and counseling.
7.4.4 Registered Nurses shall participate in the implementation of the strategy of care by:
220.127.116.11 Providing care for clients whose conditions are stabilized or predictable.
18.104.22.168 Providing care for clients whose conditions are critical and/or fluctuating, under the direction and supervision of a recognized licensed authority.
22.214.171.124 Providing an environment conducive to safety and health.
126.96.36.199 Documenting nursing interventions and client outcomes.
188.8.131.52 Communicating nursing interventions and client outcomes to appropriate health team members.
7.4.5 Registered Nurses shall evaluate outcomes, which may include the client, family, significant others and health team members.
184.108.40.206 Evaluation data shall be documented and communicated appropriately;
220.127.116.11 Evaluation data shall be used as a basis for modifying health care strategies including but not limited to reassessing client health status, modifying nursing diagnoses, or prescribing changes in nursing interventions.
“Accountability” - The state of being accountable, answerable, or legally liable for actions and decisions, including supervision.
“Delegation” - Entrusting the performance of selected nursing duties to individuals qualified, competent and legally able to perform such duties while retaining the accountability for such act.
“Supervision” - The guidance by a registered nurse (RN) for the accomplishment of a function or activity. The guidance consists of the activities included in monitoring as well as establishing the initial direction, delegating, setting expectations, directing activities and courses of action, critical watching, overseeing, evaluating, and changing a course of action.
“Unlicensed Assistive Personnel” - Individuals not licensed to perform nursing tasks that are employed to assist in the delivery of client care. The term “unlicensed assistive personnel” does not include members of the client’s immediate family, guardians, or friends; these individuals may perform incidental care of the sick in private homes without specific authority from a licensed nurse (as established in 24 Del.C. §1921(a)(4) of the Nurse Practice Act).
18.104.22.168.2 The RN must be knowledgeable regarding the unlicensed assistive personnel’s education and training and have opportunity to periodically verify the individual’s ability to perform the specific tasks.
22.214.171.124.3 The RN maintains accountability for determining the appropriateness of all delegated nursing duties and responsibility for the delivery of safe and competent care. The RN is accountable for decisions made and actions taken in the course of that delegation. Unlicensed assistive personnel may not reassign a delegated act.
126.96.36.199.1 The RN may delegate only tasks that are within the scope of sound professional nursing judgment to delegate. Nursing judgments and actions include decisions made when delegating nursing tasks to others and providing supervision for those activities.
188.8.131.52.1 The following activities require nursing knowledge, judgment, and skill and may not be delegated by the RN to an unlicensed assistive person. These exclusions do not apply to Advanced Practice Nurses.
184.108.40.206.5 Specific tasks involved in the implementation of the plan of care which require nursing judgment, skill, or intervention, that include, but are not limited to: performance of sterile invasive procedures involving a wound or anatomical site; nasogastric, newly established gastrostomy and jejunostomy tube feeding; nasogastric, jejunostomy and gastrostomy tube insertion or removal; suprapubic catheter insertion and removal; (phlebotomy is not considered a sterile, invasive procedure);
7.5 Standards of Practice for the Licensed Practical Nurse
7.5.1 Standards related to the Licensed Practical Nurse’s contributions to the nursing process.
220.127.116.11 At the direction and under the supervision of a recognized licensed authority, the Licensed Practical Nurse shall contribute to the nursing process and document nursing assessments of individuals and groups by:
18.104.22.168.1 Collecting objective and subjective data from observations, examinations, interview and written records in an accurate and timely manner. The data include but are not limited to:
22.214.171.124.1.1 Biophysical and emotional status and observed changes;
126.96.36.199.1.2 Growth and development;
188.8.131.52.1.3 Ethno-cultural, spiritual, socio-economic, and ecological background;
184.108.40.206.1.4 Family health history;
220.127.116.11.1.5 Information collected by other health team members;
18.104.22.168.1.6 Ability to perform activities of daily living;
22.214.171.124.1.7 Consideration of client’s health goals;
126.96.36.199 Licensed Practical Nurses shall participate in establishing and documenting nursing diagnoses that serve as the basis for the strategy of care.
188.8.131.52 Licensed Practical Nurses shall participate in developing strategies of care based on assessment and nursing diagnoses.
184.108.40.206.1 Contributing to setting realistic and measurable goals for implementation.
220.127.116.11.2 Participating in identifying measures to maintain comfort, to support human functions and responses to maintain an environment conducive to well-being, and to provide health teaching and counseling.
18.104.22.168.3 Contributing to setting client priorities.
22.214.171.124 Licensed Practical Nurses shall participate in the implementation of the strategy of care by:
126.96.36.199.1 Providing care for clients whose conditions are stabilized or predictable.
188.8.131.52.2 Providing care for clients whose conditions are critical and/or fluctuating, under the directions and supervision of a recognized licensed authority.
184.108.40.206.3 Providing an environment conducive to safety and health.
220.127.116.11.4 Documenting nursing interventions and outcomes.
18.104.22.168.5 Communicating nursing interventions and outcomes to appropriate health team members.
22.214.171.124 Licensed Practical Nurses shall contribute to evaluating outcomes through appropriate documentation and communication.
126.96.36.199 ”Dispensing” means providing medication according to an order of a practitioner duly licensed to prescribe medication. The term shall include both the repackaging and labeling of medication from bulk to individual doses.
188.8.131.52 “Prescription Label” - a label affixed to every prescription or drug order which contains the following information at a minimum.
184.108.40.206 “Standing order” - An order written by the practitioner which authorizes a designated registered nurse or nurses to dispense prescription drugs to his/her patients(s) according to the standards listed below.
220.127.116.11.1 Licensed Practical Nurses may provide to a patient pre-packaged medications in accordance with the order of a practitioner duly licensed to prescribe medication where such medications have been pre-packaged by a person with lawful authority to dispense drugs.
18.104.22.168.2 Licensed Practical Nurses, per written order of a physician, dentist, podiatrist, advanced practice nurse, or other practitioner duly licensed to prescribe medication, may add the name of the client to a preprinted label on a pre-packaged medication.
22.214.171.124.10 Record keeping must include the maintenance of the original written prescription of drug order for at least three years, allow retrospective review of accountability, and provide an audit trail. All dispensing records must be maintained on site, and available for inspection by authorized agents of the Board of Health, Pharmacy, and Nursing.
126.96.36.199.11 The dispensing nurse shall assume the responsibility of patient counseling of drug effects, side-effects, desired outcome, precautions, proper storage, unique dosing criteria, drug interactions, and other pertinent data, and record evidence of patient education.
7.7 Intravascular Therapy by Licensed Nurses. Intravascular therapy encompasses several components, some of which require primarily skill proficiency with a minimum of critical judgment. Other aspects of intravascular therapy require skill proficiency and more importantly a high degree of knowledge, critical judgement and decision making to perform the function safely.
7.7.1 Definition of Terms.
188.8.131.52 Intravascular therapy (IV) - is the broad term including the administration of fluids and medications, blood and blood derivatives into an individual's vascular system.
184.108.40.206 Intravascular therapy maintenance - Monitoring of the therapy for changes in patient's condition, appropriate flow rate, equipment function, the hanging of additional fluid containers and the implementation of site care.
220.127.116.11 Intravenous and intra-arterial medications - are drugs administered into an individual's vascular system by any one of the following methods:
18.104.22.168.1 By way of infusion diluted in solution or suspended in fluid and administered over a specified time at a specified rate.
22.214.171.124.2 Through an established intra-vascular needle or catheter (referred to as "IV push").
126.96.36.199.3 By venipuncture carried out for the sole purpose of administering the medication. This method is referred to as direct medication injection (direct IV push).
188.8.131.52 Intravenous fluids - include solutions, vitamins, nutrient preparations, and commercial blood fractions designed to be administered into an individual's vascular system. Whole blood and blood components, which are administered in the same manner, are considered intravenous fluids in this definition.
184.108.40.206 Subcutaneous Infusion- Continuous infusion or intermittent injection of medication into the layer of fatty tissue between the skin and muscle using a subcutaneous needle.
220.127.116.11 Supervision - a registered nurse, licensed physician or dentist is physically present in the unit where the patient is being provided care, or within immediate electronic/telephone contact.
18.104.22.168 Termination of intravascular therapy - Cessation of the therapy either by withdrawing a needle or catheter from an individual’s vascular system or by discontinuing the infusion and maintaining the device as a reservoir.
22.214.171.124 Vascular access - Utilization of an established device or the introduction of a needle or catheter into an individual’s vascular system.
126.96.36.199 Vascular system - is composed of all peripheral and central veins and arteries.
188.8.131.52 Venipuncture - Introduction of a needle or catheter into an individual's peripheral vein for the purpose(s) of withdrawing blood or establishing an infusion or administering medications.
7.7.2 Conditions Of Performing Intravascular Therapy Procedures By Licensed Nurses
184.108.40.206 Intravascular therapy must be authorized by a written order from a state licensed and authorized prescriber.
220.127.116.11 The performance of any procedures of intravascular therapy by a licensed practical nurse will be done under the supervision of a registered nurse, APN, or person licensed to practice medicine, surgery, or podiatry.
18.104.22.168 Admixed intravascular solutions documented and instituted by one licensed nurse and subsequently interrupted may be re-instituted by another licensed nurse after confirmation with the state licensed and authorized prescriber's order.
22.214.171.124 Admixed intravascular solutions documented and prepared by one licensed nurse may be initiated or continued by another licensed nurse after confirmation with the state licensed and authorized prescriber's order.
126.96.36.199 Intradermal or topical anesthetics may be used by the RN or LPN when initiating vascular access therapy in various situations or settings, provided there is an authorized prescriber’s order and organizational policy/procedure to support use of these medications. All RNs and LPNs must have documented educational preparation according to the employing agency’s policies and procedures. Documented evidence must include both theoretical instruction including anatomy and physiology, pharmacology, nursing management and education of patients and demonstration of clinical proficiency in performance of the task.
7.7.3 Functional Scope of Responsibility for Intravascular Therapy Procedures
188.8.131.52 Registered Nurses bear the responsibility and accountability for their nursing practice under the license granted by the Board of Nursing and are permitted to perform the following:
184.108.40.206.1 Assessment of the patient and the prescribed intravascular therapy before, during and after the therapy is carried out.
220.127.116.11.2 Acceptance and confirmation of intravascular therapy order(s).
18.104.22.168.3 Calculation of medication dosage and infusion rate for intravascular therapy administration.
22.214.171.124.4 Confirmation of medication dosage and infusion rate for intravascular therapy administration.
126.96.36.199.5 Addition of prescribed medications in intravascular solution, labeling and documenting appropriately.
188.8.131.52.6 Start initial solution or add replacement fluids to an existing infusion as prescribed.
184.108.40.206.7 Vascular access for establishing an infusion or administering medications.
220.127.116.11.8 Administration of medications by "IV push".
18.104.22.168.9 Intravascular therapy maintenance.
22.214.171.124.10 Termination of intravascular therapy, including the removal of subclavian and PICC lines.
126.96.36.199.11 Access the vascular system for the purpose of the withdrawal of blood and to monitor the patient's condition before, during, and after the withdrawal of blood.
188.8.131.52 Licensed Practical Nurses bear the responsibility and accountability for their nursing practice under the license granted by the Board of Nursing and are permitted to perform the following for peripheral lines:
184.108.40.206.1 Acceptance and confirmation of intravascular therapy order(s).
220.127.116.11.2 Calculation of medication dosage and infusion rate of intravascular medications prescribed. This does not include titration.
18.104.22.168.3 Confirmation of medication dosage and infusion rate for intravascular therapy administration.
22.214.171.124.4 Addition of medications in intravascular solutions, label and document appropriately.
126.96.36.199.5 Venipuncture with needle device to establish access to the peripheral vascular system.
188.8.131.52.6 Start initial solution or add replacement fluids to an existing infusion as prescribed.
184.108.40.206.7 Intravascular therapy maintenance including the flushing of peripheral lines with Heparin and/or saline solution.
220.127.116.11.8 Termination of peripheral intravascular therapy.
18.104.22.168.9 Performance of venipuncture for the purpose of the withdrawal of blood and to monitor the patient's condition before, during and after the withdrawal of blood.
22.214.171.124 The Licensed Practical Nurse is permitted to perform the following procedures for central lines:
126.96.36.199.1 Acceptance of intravascular therapy order(s).
188.8.131.52.2 Calculation of medication dosage and infusion rate of intravascular medications prescribed. This does not include titration.
184.108.40.206.3 Confirmation of medication dosage and infusion rate for intravascular therapy administration.
220.127.116.11.4 Addition of medications in intravascular solutions, label and document appropriately.
18.104.22.168.5 Intravascular therapy maintenance, including the flushing of central lines with Heparin and/or saline solution.
22.214.171.124.6 Dressing and tubing changes, including PICC lines.
126.96.36.199.7 Addition of replacement fluids to an existing infusion as prescribed.
7.7.4 Special Infusion Therapy Procedures by Registered Nurses
188.8.131.52 Chemotherapy - Only intravascular routes are addressed in these rules. Review of the Oncology Nursing Society’s current guidelines is recommended before the administration of anti-neoplastic agents.
184.108.40.206.1 Definition of Terms
220.127.116.11.1.1 Cancer Chemotherapy - is the broad term including the administration of anti-neoplastic agents into an individual's vascular system.
18.104.22.168.1.2 Anti-neoplastic agents - are those drugs which are administered with the intent to control neoplastic cell growth.
22.214.171.124.2 The Registered Nurse who administers cancer chemotherapy by the intravascular route must have documented educational preparation according to the employing agency's policies and procedures.
126.96.36.199.3 The Registered Nurse must have documented evidence of knowledge and skill in the following:
188.8.131.52.3.1 Pharmacology of anti-neoplastic agents
184.108.40.206.3.2 Principles of drug handling and preparation
220.127.116.11.3.3 Principles of administration
18.104.22.168.3.4 Vascular access
22.214.171.124.3.5 Side effects of chemotherapy on the nurse, patient, and family
126.96.36.199 Central Venous Access Via Peripheral Veins
188.8.131.52.1 Definition of Terms
184.108.40.206.1.1 Central venous access - is that entry into an individual's vascular system via the insertion of a catheter into a peripheral vein threaded through to the superior vena cava with placement confirmed by x-ray.
220.127.116.11.2 The Registered Nurse who performs central venous access via peripheral veins must have documented educational preparation according to the employing agency's policies and procedures.
18.104.22.168.3 Documented evidence must include, but is not limited to, evidence of both theoretical instruction and clinical proficiency in performance of the task.
22.214.171.124.3.1 Theoretical instruction must include, but is not limited to, anatomy and physiology, pharmacology, nursing management, and education of patients as they relate to central venous access via peripheral veins.
126.96.36.199.3.2 A preceptor must supervise the learning experience and must document the Registered Nurse's competency in the performance of the procedure.
188.8.131.52.4 Specially trained PICC nurses may determine the location of the distal tip of a peripherally inserted central catheter by initial or repeat chest radiograph studies prior to administration of the prescribed therapy.
184.108.40.206 Pain Management via Epidural Catheter
220.127.116.11.1 It is within the scope of practice of a Registered Nurse to instill analgesics (opiates)/low dose anesthetics at analgesic levels into an existing catheter under the following conditions/exceptions:
18.104.22.168.1.1 The epidural catheter is in place.
22.214.171.124.1.2 The position of the epidural catheter was verified as correct by a physician at the time of insertion.
126.96.36.199.1.3 Bolus doses and/or continuous infusions, as pre-mixed by anesthesiologists, C.R.N.A.s, or pharmacists, of epidural analgesics/low does anesthetics at analgesic levels can be administered by the Registered Nurse only after the initial dose has been administered. Changes in medication and/or dosage of the same medication are not defined as the initial dose.
188.8.131.52.1.4 Only analgesics (opiates)/low dose anesthetics at analgesic levels will be administered via this route for acute and chronic pain management.
184.108.40.206.1.5 The Registered Nurse must complete a course that includes, but is not limited to, a) anatomy, physiology, pharmacology, nursing management, assessment, and education of patients as they relate to epidural administration of opiates/low dose anesthetics at analgesic levels; b) a credentialed preceptor must supervise the learning experience and must document the Registered Nurse's clinical competency in the performance of the procedure.
220.127.116.11.1.6 The Registered Nurse may not insert or remove epidural catheters.
18.104.22.168.1.2 Intraosseous infusions- a method of obtaining immediate vascular access, especially in children, by percutaneous insertion of an intraosseous needle into the bone marrow cavity of a long bone where substances may be injected or infused and are readily absorbed into the general circulation.
22.214.171.124.3.1 Theoretical instruction must include, but is not limited to, anatomy and physiology, pharmacology, nursing management, and education of patients as they relate to intraosseous access, infusions, or removal.
126.96.36.199.1 It is within the role of the RN to manage care for patients receiving analgesia by catheter techniques by the perineural route of administration to alleviate pain. This does not include the epidural route.
188.8.131.52.2 A RN who has received the proper additional education and training may re-inject medication (bolus dose) following establishment of an appropriate therapeutic range and adjust drug infusion rate, intervene with side effects and complications, replace empty drug reservoirs, refill implanted drug reservoirs, trouble shoot infusion devices, change infusion device batteries, tubings, and dressings, discontinue therapy, and remove catheters in compliance with a licensed healthcare provider’s orders.
184.108.40.206.3.5 Recognize emergency situations and institute nursing interventions in compliance with established institution/healthcare facility policies, procedures, and guidelines and licensed healthcare provider orders.
220.127.116.11.3.7 Demonstrate knowledge of the legal ramifications of the management and monitoring of analgesia by catheter techniques, including the RN’s responsibility and liability in the event of untoward reactions or life-threatening complications.
18.104.22.168.3.8 Identify patient/family educational needs and limitations and provide the patient/family with patient-focused information/education regarding the specific catheter analgesia/infusion device using appropriate teaching methods.
7.8 Exclusions of Health Care Acts pursuant to 24 Del.C. §1921(a)(19)
7.8.1 Health care acts that shall not be delegated by a competent individual who does not reside in a medical facility or a facility regulated pursuant to Chapter 11 of Title 16 include the following:
22.214.171.124 original intravenous insertion
126.96.36.199 original suprapubic catheter insertion or removal
188.8.131.52 newly established gastrostomy or jejunostomy tube feeding
184.108.40.206 original nasogastric and gastrostomy tube insertion or removal
220.127.116.11 any jejunostomy tube insertion or removal
18.104.22.168 sterile invasive procedures not normally taught to patients and caregivers by licensed health care professionals
These rules and regulations are adopted by the Delaware Board of Nursing under the authority of the Delaware Nurse Practice Act, 24 Del.C. §§1902(d), 1906(1), 1906(7).
8.3.1 These rules and regulations govern the educational and experience requirements and standards of practice for the Advanced Practice Registered Nurse. Prescribing medications and treatments independently is pursuant to the Rules and Regulations promulgated by the Board as defined in 24 Del.C. §1906(20). The Advanced Practice Registered Nurse is responsible and accountable for her or his practice. Nothing herein is deemed to limit the scope of practice or prohibit a Registered Nurse from engaging in those activities that constitute the practice of professional nursing and/or professional nursing in a specialty area.
“Advanced Practice Registered Nurse” as defined in 24 Del.C. §1902(c)(1). Such a nurse will be given the title Advanced Practice Registered Nurse by state licensure, and may use the title Advanced Practice Registered Nurse within his/her specific specialty area.
“Advanced Practice Registered Nurse Role and Population Focus” Advanced practice roles include the C.R.N.A., C.N.M., C.N.S. and C.N.P. Population foci include: adult/gerontology, family/individual across the lifespan, neonatal, pediatric, psychiatric/mental health, or women’s health/gender related.
“Audit” The verification of existence of a collaborative agreement for a minimum of 10% of the total number of licenses issued during a specified time period.
“Board” The Delaware Board of Nursing
“Certified Nurse Midwife (C.N.M.)” A Registered Nurse who is a provider for normal maternity, newborn and well-woman gynecological care. The CNM designation is received after completing an accredited post-basic nursing program in midwifery at schools of medicine, nursing or public health, and passing a certification examination administered by the American Midwifery Certification Board (AMCB) or other nationally recognized, Board of Nursing approved certifying organization.
“Certified Nurse Practitioner (C.N.P.)” A Registered Nurse with advanced nursing educational preparation who is a provider of primary healthcare in a variety of settings with a focus on a specific area of practice. The C.N.P designation is received after graduation from a Master’s program or from an accredited post-basic C.N.P certificate program of at least one academic year in length in a nurse practitioner specialty such as acute care, adult, family, geriatric, pediatric, or women’s health, etc. The C.N.P must have national certification in the area of specialization at the advanced level by a certifying agency which meets the established criteria approved by the Delaware Board of Nursing.
“Certified Registered Nurse Anesthetist (C.R.N.A.)” A Registered Nurse who has graduated from a nurse anesthesia educational program accredited by the American Association of Nurse Anesthetists’ Council on Accreditation of Nurse Anesthesia Educational programs, and who is certified by the American Association of Nurse Anesthetists’ Council on Certification of Nurse Anesthetists or other nationally recognized, Board of Nursing approved certifying organization.
“Clinical Nurse Specialist (C.N.S.)” A Registered Nurse with advanced nursing educational preparation who functions in primary, secondary, and tertiary settings with individuals, families, groups, or communities. The CNS designation is received after graduation from a Master’s degree program in a clinical nurse specialty or post Master’s certificate, such as gerontology, maternal-child, pediatrics, psych/mental health, etc. The CNS must have national certification in the area of specialization at the advanced level. The certifying agency must meet the established criteria approved by the Delaware Board of Nursing.
“Clinical Nursing Specialty” a delimited focus of advanced nursing practice. Specialty areas can be identified in terms of population, setting, disease/pathology, type of care or type of problem. Nursing administration does not qualify as a clinical nursing specialty.
“Collaborative Agreement” Written documentation expressing an arrangement between a licensed physician, podiatrist, or licensed Delaware health care delivery system and an advanced practice registered nurse. Only APRNs who have not practiced for at least two years and 4,000 hours or those seeking independent practice are required to maintain a collaborative agreement.
“Consultation” means the communication and decision-making process among healthcare professionals related to the treatment and care of a patient, including the exchange of clinical observations and assessments; accessing an assessment of appropriate additional resources or expertise; arrangement of appropriate referrals, testing, or studies; and development of an appropriate plan of care that includes decisions regarding the health care provided.
“Full practice authority,” as granted to an advanced practice registered nurse, means all of the following:
“Full-time hours” means at least 4,000 hours of clinical practice in no more than five years.
“Guidelines/ Protocols” Suggested pathways to be followed by an Advanced Practice Registered Nurse for managing a particular medical problem. These guidelines/protocols may be developed collaboratively by an Advanced Practice Registered Nurse and a licensed physician, or a podiatrist, or licensed Delaware health care delivery system.
“Independent practice” means practice and prescribing by an APRN who is not subject to a collaborative agreement and works outside the employment of an established health care organization, health care delivery system, physician, podiatrist, or practice group. Independent practice shall be in an area substantially related to the population and focus of the APRN’s education and certification.
“National Certification” That credential earned by a nurse who has met requirements of a Board approved certifying agency.
“Pharmacology/Pharmacotherapeutics” Refers to any course, program, or offering that would include, but not be limited to, the identification of individual and classes of drugs, their indications and contraindications, their likelihood of success, their dosages, their side-effects and their interactions. It also encompasses clinical judgment skills and decision making. These skills may be based on thorough interviewing, history taking, physical assessment, test selection and interpretation, patho-physiology, epidemiology, diagnostic reasoning, differentiation of conditions, treatment decisions, case evaluation and non-pharmacologic interventions.
“Post Basic Program” A combined didactic and clinical/preceptored program of at least one academic year of full time study in the area of advanced nursing practice with a minimum of 400 clinical/preceptored hours. The program must be one offered and administered by an approved health agency and/or institution of higher learning. Post basic means a program taken after licensure is achieved.
“Scope of Specialized Practice” That area of practice in which an Advanced Practice Registered Nurse has a Master’s degree or a post-basic program certificate in a clinical nursing specialty with national certification.
“Supervision” Direction given by a licensed physician or Advanced Practice Registered Nurse to an Advanced Practice Registered Nurse practicing pursuant to a temporary permit. The supervising physician or Advanced Practice Registered Nurse must be periodically available at the site where care is provided, or available for immediate guidance.
8.5.1 Any person holding a certificate of state licensure as an Advanced Practice Registered Nurse that is valid on July 31, 2014 shall be eligible for renewal of such licensure under the conditions and standards prescribed herein for renewal of licensure.
8.6.1 APRNs shall comply with the standards for RNs as well as the standards of the national professional nursing associations recognized by the Board of Nursing. Standards for a specific role and population focus supersede standards for RNs where conflict between the standards, if any, exists. APRNs shall practice within standards established by the Board of Nursing and assure patient care is provided according to relevant patient care standards recognized by the Board of Nursing, including standards of national professional nursing associations. Advanced Practice Registered Nurses view clients and their health concerns from an integrated multi-system perspective.
8.6.2 Standards provide the practitioner with a framework within which to operate and with the means to evaluate his/her practice. In meeting the standards of practice of nursing in the advanced role, each practitioner:
22.214.171.124 Initiates and applies clinical treatments based on expert knowledge and technical competency to client populations with problems ranging from health promotion to complex illness and for whom the Advanced Practice Registered Nurse assumes primary care responsibilities. These treatments include, but are not limited to psychotherapy, administration of anesthesia, and vaginal deliveries;
126.96.36.199 Establishes a collaborative agreement with a licensed physician, podiatrist, or licensed Delaware health care delivery system to facilitate consultation and/or referral as appropriate in the delivery of health care to clients for graduate APRNs or APRNs seeking independent practice.
8.6.3 In addition to these standards, each nurse certified in an area of specialization and recognized by the Board to practice as an Advanced Practice Registered Nurse is responsible for practice at the level and scope defined for that specialty certification by the agency which certified the nurse.
8.7.17 Removing epidural catheters by Nurse Practitioners, Clinical Nurse Specialists and Certified Nurse Midwives after specialized training in collaboration with the facility department of anesthesiology, including population specific advanced life support.
188.8.131.52 Has an application process and credential review which includes documentation that the applicant’s education is in the advanced nursing practice role and population focus being certified, and that the applicant’s clinical practice is in the same role and population focus.
184.108.40.206 Has mechanisms in place for communication to Boards of Nursing for timely verification of an individual’s certification status, changes in certification status, and changes in the certification program, including qualifications, test plan and scope of practice.
220.127.116.11 Have committed no acts or omissions, which are grounds for disciplinary action in another jurisdiction or, if such acts have been committed and would be grounds for disciplinary action as set forth in statute or regulation, the Board has found, after investigation, that sufficient restitution has been made.
8.9.2 An application for licensure to practice as an Advanced Practice Registered Nurse shall be submitted on forms supplied by the Board along with the required non-refundable fee. A completed application provides the following information: Graduation from an APRN graduate or post-graduate program accredited by a nursing accrediting body that is recognized by the U.S. Secretary of Education and/or the Council for Higher Education Accreditation (CHEA), or its successor organization; documentation shall verify date of graduation, credential conferred, number of clinical hours completed, completion of three separate graduate level courses in advanced physiology and pathophysiology, advanced health assessment, advanced pharmacokinetics and pharmacotherapeutics of all broad categories of agents, role and population focus of the education program, and evidence of meeting the standards of nursing education in this state.
8.9.3 The APRN applicant shall be required to furnish the name(s) of the licensed physician, podiatrist, or licensed Delaware health care delivery system with whom the applicant will be collaborating (if the applicant has not practiced at least two years and a minimum of 4,000 hours).
8.9.5 In order to be licensed, all APRN applicants must be currently licensed as an RN or hold a privilege to practice as an RN in this state and take and pass the appropriate national certification examination in the role and population focus congruent with educational preparation.
8.9.6 A Registered Nurse meeting requirements set forth in these Rules and Regulations may be issued a license as an Advanced Practice Registered Nurse in the role and population focus in which the nurse has been nationally certified at the advanced level and/or has earned a Master’s degree in the same role and population.
8.9.7 The Board may refuse to issue, revoke, suspend or refuse to renew the license as an Advanced Practice Registered Nurse or otherwise discipline an applicant or a practitioner who fails to meet the requirements for licensure as an Advanced Practice Registered Nurse or as a registered nurse, or who commits any disciplinary offense under the Nurse Practice Act, 24 Del.C. Ch. 19, or the Rules and Regulations promulgated pursuant thereto.
8.9.8 A Registered Nurse who is duly enrolled as a bona fide student in an approved educational program for Advanced Practice Registered Nurses is not required to obtain an APRN license for the clinical requirements of the program, so long as the student is always under the direct supervision of a qualified instructor.
18.104.22.168 The individual submits proof of graduation from a nationally accredited or Board approved Master’s or certificate advanced practice registered nursing program, and has passed the certification examination, or
22.214.171.124 The individual submits proof of admission into the approved certifying agency’s examination or is seeking a temporary permit to practice under supervision to accrue the practice hours required to sit for the certifying examination or has accrued the required practice hours and is scheduled to take the first advanced certifying examination upon eligibility or is accruing the practice hours referred to in 126.96.36.199; or,
188.8.131.52.1 The applicant may petition the Board of Nursing to extend a temporary permit under supervision until results of the next available certification exam are available by furnishing the following information:
8.10.8 Any person practicing or holding oneself out as an Advanced Practice Registered Nurse in any category without a Board authorized license in such category shall be considered an illegal practitioner and shall be subject to the penalties provided for violations of the Law regulating the Practice of Nursing in Delaware, (24 Del.C. Ch. 19).
8.11.1 The Board may, by endorsement, license as an Advanced Practice Registered Nurse an applicant who is duly licensed as an Advanced Practice Registered Nurse or is entitled to perform similar services under a different title under the laws of another state, territory or foreign country if, in the opinion of the Board, the applicant meets all qualifications specified by these regulations for Advanced Practice Registered Nurses in this State.
8.11.2 Applicants must submit documentation of graduation from a graduate or post-graduate level APRN program, as evidenced by an official transcript or other official documentation acceptable by the Board, verifying date of graduation and credential conferred; number of clinical hours completed; completion of three separate graduate level courses in advanced physiology and pathophysiology, advanced health assessment, advanced pharmacokinetics and pharmacotherapeutics of all broad categories of agents; and role and population focus of the education program.
8.11.3 Applicants must meet the practice requirement of 1500 hours in the past five years or no less than 600 hours in the past two years in the role and population focus consistent with certification and educational preparation.
8.11.4 An applicant who has not practiced at least two years and a minimum of 4,000 hours shall be required to furnish the name(s) of the licensed physician, podiatrist, or licensed Delaware health care delivery system with whom the applicant will be collaborating.
8.12.2 The Advanced Practice Registered Nurse must have practiced a minimum of 1500 hours in the past five years or no less than 600 hours in the past two years in the role and population focus in which licensure has been granted.
184.108.40.206 Faculty members teaching in graduate level clinical courses may count a maximum of 500 didactic course contact hours in the past five years or 200 in the past two years and all hours of direct on-site clinical supervision of students to meet the practice requirement.
220.127.116.11 An Advanced Practice Registered Nurse who does not meet the practice requirement may be issued a temporary permit to practice under the supervision of a person licensed to practice medicine, surgery, or advanced practice nursing, as determined on an individual basis by the Board.
8.12.3 The Advanced Practice Registered Nurse who has not practiced at least 2 years and 4000 hours will be required to furnish the name(s) of the licensed physician, podiatrist, or licensed Delaware health care delivery system with whom a current collaborative agreement exists. For APRNs who intend to apply for independent practice, the collaborative agreement must be maintained until independent practice is granted by the Board.
18.104.22.168 An applicant for renewal of APRN licensure shall submit a detailed explanation and supporting documentation when the applicant’s answers to questions regarding background and current certification/recertification by a national professional certification organization indicate that the applicant does not meet the requirements for renewal of licensure.
8.12.5 To reinstate licensure status as an Advanced Practice Registered Nurse, the requirements for recertification and 1500 hours of practice in the past five years or no less than 600 hours in the past two years in the role and population must be met.
8.12.7 An individual who applies for licensure reinstatement and who has been out of practice for more than five years shall provide evidence of successfully completing a Board approved APRN refresher program within one year prior to application for reinstatement. If no refresher is available the applicant must complete 600 hours of supervised clinical practice in the appropriate advanced practice role and population focus by a qualified preceptor within one year prior to reinstatement.
22.214.171.124 A preceptor must hold an active license to practice as an APRN or physician that is not encumbered and practices in a comparable practice focus. Evidence of satisfactory completion of the supervised practice must be submitted in writing to the Board of Nursing; likewise, unsatisfactory performance must be reported to the Board in a timely manner.
126.96.36.199 APRNs who have been out of practice more than two years but less than five must submit 24 hours of CE with 12 hours in pharmacotherapeutics and 12 hours in the clinical management of patients taken within one year prior to application.
188.8.131.52 APRNs who have been out of practice more than five years must submit 45 hours of pharmacotherapeutics CE taken within one year prior to application in addition to the advanced practice refresher program.
8.13.1 The Board may select licensees for audit two months prior to renewal in any biennium. The Board shall notify the licensees that they are to be audited for compliance with the requisite practice hours and continuing education contact hours.
184.108.40.206 Upon receipt of such notice, the licensee must submit verification of compliance with APRN practice hours on a form supplied by the Board office that includes employer’s name, title, address, telephone number, job title, and dates of employment. Upon receipt of such notice, the licensee must submit the form to the employer and the employer will submit the completed form directly to the Board office.
8.14.2 Prescription Order - includes the prescription date, the name of the patient; the name, title, address, area of specialization and business telephone number of the advanced practice registered nurse prescriber; the full name, strength, dosage, route, quantity, amount to be dispensed; directions for use; and number of refills of the drug product or device prescribed; and must bear the name and prescriber ID number and signature of the advanced practice registered nurse prescriber, and when applicable, prescriber’s D.E.A. number and signature. There must be lines provided to show whether the prescription must be dispensed as written or substitution is permitted.
8.14.3 APRNs are authorized to prescribe, procure, administer, store, dispense, and furnish over the counter, legend, and controlled substances pursuant to applicable state and federal laws and within the APRN’s role and population focus.
8.14.4 APRNs may prescribe, administer, and dispense legend medications including Schedule II - V controlled substances, (as defined in the Controlled Substance Act and labeled in compliance with 24 Del.C. §2522, parenteral medications, medical therapeutics, devices and diagnostics.
220.127.116.11 APRNs may request and issue professional samples of legend, including schedule II-V controlled substances, and over-the-counter medications that must be labeled in compliance with 24 Del.C. §2522.
8.14.5 APRNs may order and prescribe non-pharmacological interventions including: medical devices and durable medical equipment, nutrition, blood, and blood products; diagnostic and supportive services including home health care, hospice, and physical and occupational therapy.
8.14.6 APRNs may: diagnose, prescribe and institute therapy or referrals of patients with the APRN’s role and population foci to health care agencies, health care providers, and community resources; pronounce death and sign death certificates; seek consultation regarding treatment and care of patients; and be designated as the primary care provider by an insurer or health services corporation.
8.14.7 APRNs licensed in Delaware prior to September 1, 2015 who were not previously granted prescriptive authority must meet the following qualifications in order to be granted prescriptive authority:
18.104.22.168 Show evidence of at least thirty hours of advanced pharmacology and pharmacotherapeutics related continuing education within the two years prior to application for prescriptive authority. This may be continuing education programs or a three credit, semester long graduate level course. The thirty hours may also occur during the APRN program as integrated content as long as this can be documented.
22.214.171.124 Show evidence of having current prescriptive authority in another jurisdiction and completion of a minimum of ten hours of approved pharmacology/pharmacotherapeutics related continuing education within the area of specialization and licensure within the past two years.
126.96.36.199 Maintain competency through a minimum of ten hours of Board approved pharmacology/pharmacotherapeutics related continuing education within the area of specialization and licensure per biennium. The pharmacology/ pharmacotherapeutics content may be a separate course or integrated within other offerings.
8.15.1 Practice or prescriptive authority may be restricted, suspended or revoked where the advanced practice registered nurse has been found to have committed unprofessional conduct in his or her practice or prescriptive authority or if his or her mental or physical faculties have changed or deteriorated in such a manner as to create an inability to practice or prescribe with reasonable skill or safety to patients.
188.8.131.52 The use or attempted use of any false, fraudulent or forged statement or document or use of any fraudulent, deceitful, dishonest or immoral practice in connection with any acquisition or use of prescriptive authority or practice;
184.108.40.206 Unjustified failure upon request to divulge information relevant to authorization or competence to practice or exercise prescriptive authority to the Executive Director of the Board of Nursing or to anyone designated by him or her to request such information.
8.15.3 Complaints concerning the use or misuse of practice or prescriptive authority received by the Division of Professional Regulation or the Board of Nursing shall be investigated in accordance with the provisions of Title 29, Section 8807 governing investigations by the Division of Professional Regulation.
8.16.1 All new graduate APRNs are required to practice under a collaborative agreement for at least two years and 4,000 hours in the applicable role and population foci. If the graduate APRN is not seeking independent practice, s/he is not required to maintain the agreement after that time.
8.16.3 APRNs who seek to obtain independent practice must demonstrate that they have practiced under a collaborative agreement for at least two years and 4,000 hours in the applicable role and population foci within an established health care organization, licensed health care delivery system, physician, podiatrist, or practice group before becoming eligible for independent practice. In order to practice independently, the APRN must apply to the APRN committee in accordance with the Board’s statute and regulations.
8.17.1 Only those APRNs granted independent practice by the Board may practice outside the employment of an established health care organization, licensed health care delivery system, physician, podiatrist, or practice group, and such independent practice shall be limited to an area substantially related to the role and population foci of the APRN’s education and certification.
8.17.2 In order to be granted independent practice, APRNs already practicing pursuant to a collaborative agreement as of July 1, 2015, shall submit a written application to the APRN Committee. The application shall be considered completed when the Division has received all of the following documentation:
220.127.116.11 Verification of Experience and Competency form from the APRN’s collaborator confirming that the applicant has practiced under a collaborative agreement within established health care organization, licensed health care delivery system, physician, podiatrist, or practice group for at least 2 years and a minimum of 4,000 full-time hours. The physician, podiatrist, or health-care delivery system party to the collaborative agreement must practice or have practiced in an area substantially related to the role and population foci of the APRN's education, certification, and planned independent practice;
18.104.22.168 Documentation that the applicant completed the two years and 4,000 hours of full-time clinical APRN practice in the applicable role and population foci within the five years preceding the date the application is submitted. To document this experience, the applicant shall submit one of the following: a notarized affidavit from an employer or employers, or tax documents showing employment; and
22.214.171.124 Verification that the applicant has committed no acts which are grounds for disciplinary action as set forth in 24 Del.C. §1922. Any nurse who has not previously submitted a criminal background check will be required to do so in order to be eligible for independent practice. Applications of APRNs who have committed acts which are grounds for disciplinary action under 24 Del.C. §1922 will be evaluated on a case by case basis; and
8.17.3 APRNs who have not practiced for at least two years and 4,000 hours under a collaborative agreement in the applicable role and population foci as of July 1, 2015, shall submit all of the above upon completion of the requisite two years with at least 4,000 hours as well as a Verification of Compliance form from the APRN’s collaborator, confirming that the applicant has met all of the below listed benchmarks, metrics, and competencies in the APRN’s role and population foci.
8.18.1 Competency: APRNs who have not practiced for at least two years and 4,000 hours under a collaborative agreement as of July 1, 2015 will obtain a collaborative agreement with a health-care delivery system, physician, or podiatrist who agrees to provide guidance and feedback on the delivery of patient care within the APRN’s role and population foci.
8.18.3 Metrics: The collaborator and APRN will agree to the delivery of patient care for at least 95% of the APRN’s cases at the conclusion of the collaborative agreement period. The APRN must maintain a practice log of the reviewed cases and level of agreement.
"Approved Method" means a planned educational experience, as described in 9.3.
"Approved Provider" means an entity that is one of the following:
"Biennium" means the two year period of licensure beginning in an odd numbered year and ending in the next odd numbered year for the Registered Nurse and the two year period of licensure beginning in an even-numbered year and ending in the next even numbered year for the Licensed Practical Nurse.
"Contact Hour" means one contact hour equals a minimum of 60 minutes. One half contact hour equals a minimum of 30 minutes.
"Continuing Education" means those professional experiences designed to enrich the nurse's contribution to health care and for the purpose of protecting the public health, safety, and welfare.
"Orientation" means the means by which nurses are introduced to the philosophy, goals, policies, procedures, role expectations, physical facilities and special services in a specific work setting. Orientation programs do not meet the continuing education requirements of these rules.
126.96.36.199 The Board derives its authority under 24 Del.C. §1906(19), to create continuing education requirements as a prerequisite to obtaining a current license and to establish an audit system to assure compliance. This requirement is in addition to the practice requirement as stated in 6.6.
188.8.131.52.1 During each biennium, each Registered Nurse must earn 30 contact hours and each Licensed Practical Nurse must earn 24 hours, to be credited to that biennium. At least 3 of these contact hours must be in the area of substance abuse.
184.108.40.206.1 To obtain a Registered Nurse or Licensed Practical Nurse license for the next biennium period, the licensee shall submit an attestation indicating the completion of all continuing education requirements for that biennium.
220.127.116.11.2 To obtain a Registered Nurse or Licensed Practical Nurse license through reinstatement, the applicant shall submit, along with the reinstatement application and fee, a completed report on a form provided by the Board office, listing and attesting to the completion of all continuing education requirements for the two years immediately preceding application.
18.104.22.168.1 A Registered Nurse who has endorsed into Delaware during a biennium or whose license was reactivated or reinstated during a biennium must earn 15 contact hours if more than a full calendar year remains in the biennium to obtain a Registered Nurse license for the next biennium period. A Licensed Practical Nurse must earn 12 contact hours if more than a full calendar year remains in the biennium to obtain a Licensed Practical Nurse license for the next biennium period. At least 3 of these contact hours must be in the area of substance abuse.
9.2.3 The required hours shall be completed in the period for which the license was issued. Contact hours from a previous licensure period will not count nor may credits be accumulated for use in a future licensing period.
22.214.171.124 A licensee who has had a physical or mental illness during the license period can apply to the Board of Nursing for a waiver. A waiver would provide for an extension of time or exemption from some or all of the continuing education requirements for one renewal period. Should the illness extend beyond one renewal period, a new request must be submitted.
126.96.36.199 A course offered by an accredited school, university or college for which college credit has been awarded and/or for which class attendance is necessary. This may include successful completion of challenge examinations. The course must be related to nursing.
188.8.131.52 The article, book chapter, or independent study (See 9.3.6) must be related to nursing. Proof of acceptance from the editor or the published work will document achievement of this type of continuing education. A maximum of five contact hours of continuing education may be earned per biennium by this method. Letters to the editor or opinion statements will not be recognized.
184.108.40.206 A process by which a nongovernmental agency or association certifies that an individual licensed to practice as an Advanced Practice Nurse, a Registered Nurse, or a Licensed Practical Nurse has met certain predetermined standards specified for specialty practice. National certification or recertification equals 20 contact hours awarded during the biennium. A certification/recertification document indicating the date of recognition must be available. When recertification requirements include more than 20 contact hours, the additional contact hours can be applied toward the total of 30 contact hours for R.N. or 24 contact hours for L.P.N. licensure.
220.127.116.11 A meeting that brings together participants for one or more days to discuss the latest developments and activities from individuals with special expertise in the subject matter of the conference.
18.104.22.168.1 Examples: Articles in journals designated as continuing education articles, computer-based programs, on-line continuing education courses for which there is a test of knowledge and a certificate awarded upon completion.
22.214.171.124 Activities intended to help nurses acquire, maintain, and/or increase the level of competence in fulfilling his or her assigned responsibilities, specific to the expectations of the employer. Planned inservices must be a minimum of 30 minutes in duration. NOTE: Mandatory education, such as CPR, infection control, fire, safety, patient privacy and confidentiality, and facility specific policies and practices, is not recognized as continuing education.
126.96.36.199 Educational presentations made to other health professionals that are not required by an individual’s job description. The presenter, if subject of an audit, must submit program brochures, course syllabi or letter from the provider identifying the participation of the presenter. Contact hours shall be equal to two hours for every one hour of presentation time, as well as the actual presentation time. A presentation must be a minimum of 30 minutes in length. A maximum of six contact hours of continuing education may be earned per biennium by this method.
188.8.131.52 The research project must have been done during the biennium. The licensee must submit an abstract as evidence of being one of the recognized researchers. A maximum of five contact hours of continuing education may be earned per biennium by this method.
184.108.40.206 A meeting that offers opportunities for persons with common interest or problems to meet with specialists to consider new knowledge and practices and to experience working on specific relevant tasks.
220.127.116.11 The Board derives its authority under 24 Del.C. Ch. 19, to create requirements for becoming an approved provider and maintaining that status. The Board also has the authority to develop an auditing mechanism to verify compliance with criteria for approved providers.
18.104.22.168 The approved providers shall produce evidence of their capability to adhere to criteria indicative of quality continuing education for nurses. Each provider approved under 9.1, will be assigned a provider number by the Board and shall provide an annual statement of compliance with these criteria.
22.214.171.124 Maintain records on persons awarded contact hours for a minimum of six years from their date of program completion. The records shall include the name of licensee, contact hours awarded, contact information and/or affiliation, title, and dates of offerings.
126.96.36.199 Furnish each participant with an individual record of completion that displays the following on the front of the certificate: participant's name, provider name and number, contact hours awarded, starting and ending dates of the offering, subject matter and a reminder to the participant to retain the certificate for the period of licensure.
9.5.1 An application will be sent to a potential provider upon request. Upon submission of a non-refundable fee, the required materials and a determination of the Delaware Board of Nursing that the materials fulfill the criteria for providers as specified in these Rules and Regulations, initial approval will be granted for up to three years.
188.8.131.52 A procedure that ensures the participant who successfully completes an educational activity will receive a document displaying an attendance record, number of contact hours awarded, provider name and number, title of presentation, and the date and location for each offering;
184.108.40.206 A provider number will be assigned at the time of approval and issued within two weeks. This number must be used in all correspondence with the Board. This number will be published on a list of approved providers.
220.127.116.11 Provider status must be renewed every three years by submitting a non-refundable fee and the required documentation demonstrating compliance with the established criteria as stated in this section.
18.104.22.168 Provider approval may be rescinded at any time during the approved period for noncompliance with approved provider requirements or for complaints that the Board determines indicate the program does not meet criteria.
9.6.1 The Board will randomly and on an individual basis select licensees for audit within six (6) months following the license renewal deadline. The Board shall notify the licensees within four (4) weeks of being selected that their records are to be audited for compliance with the continuing education requirements.
22.214.171.124 Upon receipt of such notice, the licensee must submit verification of compliance for the period of licensure being audited. Verification materials which may be requested include proof of attendance, academic transcripts, certificates showing number of contact hours awarded, and documentation of compliance with exceptions.
10.1.1.6 otherwise discipline a licensee as provided by 24 Del.C. §1922.
10.2.1 Any individual shall submit a written complaint of alleged violations of 24 Del.C. Ch. 19 to the Division of Professional Regulation. The Executive Director will retain a copy of the complaint.
10.2.2 Any Board member receiving a complaint alleging an applicant’s or a practitioner’s or licensee’s violation of the Nurse Practice Act should promptly forward the complaint to the Division of Professional Regulation with a copy to the Executive Director of the Board of Nursing.
10.2.3 Hearings on licensing matters and complaints filed with the Board that allege an applicant or a licensee has violated the Nurse Practice Act, 24 Del.C. Ch. 19, shall be heard and determined by the Board in accordance with the applicable provisions of the Nurse Practice Act and the Administrative Procedures Act, 29 Del.C. Ch. 101. When the applicant or licensee, prosecuting Deputy Attorney General, and appointed Board member consent, the complaint may be resolved through the Consent Agreement process in lieu of a formal disciplinary hearing before the Board.
10.3.1 Upon application made by the licensee, a suspended or probated license may be reissued or reinstated in accordance with conditions that the Board may apply, after the imposed period of discipline has concluded and after evidence is presented to satisfy the Board that the condition that lead to the disciplinary action has been corrected.
10.4.1 Nurses whose behavior fails to conform to legal and accepted standards of the nursing profession and who thus may adversely affect the health and welfare of the public may be found guilty of unprofessional conduct.
10.4.2.6 Violating professional boundaries of the nurse-patient relationship including but not limited to physical, sexual, emotional or financial exploitation of the patient or patient’s significant other(s).
10.4.2.17 Diverting, possessing, obtaining, supplying or administering illegal drugs or prescription drugs to any person, including self, except, in the case of prescription drugs, as directed by a person authorized by law to prescribe drugs.
10.4.2.20 Practicing advanced practice, professional or practical nursing in this state without a current Delaware license or permit as defined in Section 14.0 Nursing Licensure Compact Rules and Regulations.
10.4.2.22 Aiding, abetting and/or assisting an individual to violate or circumvent any law or duly promulgated rule and regulation intended to guide the conduct of a nurse or other health care provider.
10.5.1 A licensed nurse shall report, on a complaint form, names of subject individuals to the Board of Nursing if the nurse has reasonable cause to suspect that a nurse or an applicant has violated any of the grounds for discipline found in this section within thirty days of becoming aware of such information.
10.5.2 Failure to report as required by rule 10.5.1 is a disciplinable offense pursuant to 24 Del.C. §1922(a)(11).
12.2.1 The Executive Director of the Board of Nursing shall make a call for applications for potential members to fill vacancies on the Board’s advisory committees. The potential members shall submit their resumes to the Executive Director. The resumes shall be reviewed by the Executive Director and each committee chair of the Board of Nursing. They shall then make recommendations with rationales to the Board of Nursing for approval and appointment of the members to advisory committees.
12.2.4 The Executive Director shall verify members’ continued interest in serving on the Board’s advisory committees prior to expiration of their two-year term. The Executive Director shall submit the names of the committee members who are interested in serving another term to the Board of Nursing for reappointment.
126.96.36.199 Members are selected 24 Del.C. §1906(19)
188.8.131.52.1 At least one of the APN members shall be a Clinical Specialist, one APN member a Certified Nurse Midwife, one APN member a Certified Registered Nurse Anesthetist, and two APN members Nurse Practitioners. If there is no qualified APN available in the needed specialty, then appointments shall be made from APNs in other specialties.
184.108.40.206 The Executive Director of the Board of Nursing shall make a call for applications for potential members to fill vacancies on the JPC. The potential members shall submit their resumes to the Executive Director. The resumes shall be reviewed by the Executive Director and the APN member of the Board of Nursing. They shall then make recommendations to the Board of Nursing for approval and appointment of the members to the JPC.
220.127.116.11 The Executive Director shall verify members’ continued interest in serving on the JPC prior to expiration of their two-year term. The Executive Director shall submit the names of the JPC members who are interested in serving another term on the JPC to the Board of Nursing for reappointment to the JPC.
18.104.22.168 The JPC shall meet as necessary to carry out its responsibilities as defined in 24 Del.C., §1906(20).
13.1 If the report is received by the chairperson of the regulatory Board, that chairperson shall immediately notify the Director of Professional Regulation or his/her designate of the report. If the Director of Professional Regulation receives the report, he/she shall immediately notify the chairperson of the regulatory Board, or that chairperson's designate or designates.
13.2 The chairperson of the regulatory Board or that chairperson's designate or designates shall, within 7 days of receipt of the report, contact the individual in question and inform him/her in writing of the report, provide the individual written information describing the Voluntary Treatment Option, and give him/her the opportunity to enter the Voluntary Treatment Option.
13.3 In order for the individual to participate in the Voluntary Treatment Option, he/she shall agree to submit to a voluntary drug and alcohol screening and evaluation at a specified laboratory or health care facility. This initial evaluation and screen shall take place within 30 days following notification to the professional by the participating Board chairperson or that chairperson's designate(s).
13.4 A regulated professional with chemical dependency or impairment due to addiction to drugs or alcohol may enter into the Voluntary Treatment Option and continue to practice, subject to any limitations on practice the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional, deem necessary, only if such action will not endanger the public health, welfare or safety, and the regulated professional enters into an agreement with the Director of Professional Regulation or his/her designate and the chairperson of the participating Board or that chairperson's designate for a treatment plan and progresses satisfactorily in such treatment program and complies with all terms of that agreement. Treatment programs may be operated by professional Committees and Associations or other similar professional groups with the approval of the Director of Professional Regulation and the chairperson of the participating Board.
13.5 Failure to cooperate fully with the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate in regard to the Voluntary Treatment Option or to comply with their requests for evaluations and screens may disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board chairperson or that chairperson's designate or designates shall cause to be activated an immediate investigation and institution of disciplinary proceedings, if appropriate, as outlined in subsection 13.8 of this section.
13.6.1 Entry of the regulated professional into a treatment program approved by the participating Board. Board approval shall not require that the regulated professional be identified to the Board. Treatment and evaluation functions must be performed by separate agencies to assure an unbiased assessment of the regulated professional's progress.
13.6.2 Consent to the treating professional of the approved treatment program to report on the progress of the regulated professional to the chairperson of the participating Board or to that chairperson's designate or designates or to the Director of the Division of Professional Regulation or his/her designate at such intervals as required by the chairperson of the participating Board or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate, and such person making such report will not be liable when such reports are made in good faith and without malice.
13.6.4 Agreement by the regulated professional to be personally responsible for all costs and charges associated with the Voluntary Treatment Option and treatment program(s). In addition, the Division of Professional Regulation may assess a fee to be paid by the regulated professional to cover administrative costs associated with the Voluntary Treatment Option. The amount of the fee imposed under this subparagraph shall approximate and reasonably reflect the costs necessary to defray the expenses of the participating Board, as well as the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board in addition to the administrative costs associated with the Voluntary Treatment Option.
13.6.5 Agreement by the regulated professional that failure to satisfactorily progress in such treatment program shall be reported to the participating Board's chairperson or his/her designate or designates or to the Director of the Division of Professional Regulation or his/ her designate by the treating professional who shall be immune from any liability for such reporting made in good faith and without malice.
13.7 The regulated professional's records of participation in the Voluntary Treatment Option will not reflect disciplinary action and shall not be considered public records open to public inspection. However, the participating Board may consider such records in setting a disciplinary sanction in any future matter in which the regulated professional's chemical dependency or impairment is an issue.
13.8 The participating Board's chairperson, his/her designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional at any time during the Voluntary Treatment Option, restrict the practice of a chemically dependent or impaired professional if such action is deemed necessary to protect the public health, welfare or safety.
13.10 Failure to enter into such agreement or to comply with the terms and make satisfactory progress in the treatment program shall disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board shall be notified and cause to be activated an immediate investigation and disciplinary proceedings as appropriate.
13.11 Any person who reports pursuant to this section in good faith and without malice shall be immune from any civil, criminal or disciplinary liability arising from such reports, and shall have his/her confidentiality protected if the matter is handled in a nondisciplinary matter.
13.12 Any regulated professional who complies with all of the terms and completes the Voluntary Treatment Option shall have his/her confidentiality protected unless otherwise specified in a participating Board's rules and regulations. In such an instance, the written agreement with the regulated professional shall include the potential for disclosure and specify those to whom such information may be disclosed.
24 Del.C., Ch. 19A, Articles 6D and 8C of the Nurse Licensure Compact grant authority to the Compact Administrators to develop uniform rules to facilitate and coordinate implementation of the Compact.
22.214.171.124 “Board” means party state’s regulatory body responsible for issuing nurse licenses.
126.96.36.199 “Information System” means the coordinated licensure information system.
188.8.131.52 “Primary State Of Residence” means the state of a person’s declared fixed permanent and principal home for legal purposes; domicile.
184.108.40.206 “Public” means any individual or entity other than designated staff or representatives of party state Boards or the National Council of State Boards of Nursing, Inc.
As of July 1, 2005, no applicant for initial licensure will be issued a compact license granting a multi-state privilege to practice unless the applicant first obtains a passing score on the applicable NCLEX examination or any predecessor examination used for licensure.
220.127.116.11 A nurse applying for a license in a home party state shall produce evidence of the nurse’s primary state of residence. Such evidence shall include a declaration signed by the licensee. Further evidence that may be requested may include but is not limited to:
(Statutory basis:24 Del.C., Ch. 19A, Articles 2E, 4C, and 4D)
18.104.22.168 A nurse on a visa from another country applying for licensure in a party state may declare either the country of origin or the party state as the primary state of residence. If the foreign county is declared the primary state of residence, a single state license will be issued by the party state.
22.214.171.124 When a party state issues a license authorizing practice only in that state and not authorizing practice in other party states – a single state license, the license shall be clearly marked with words indicating that it is valid only in the state of issuance.
126.96.36.199 A nurse changing primary state of residence, from one party state to another party state, may continue to practice under the former home state license and multi-state licensure privilege during the processing of the nurse’s licensure application in the new home state for a period not to exceed ninety days. (Statutory basis: 24 Del.C. Ch. 19A, Articles 4B, 4C, and 4D)
188.8.131.52 The licensure application in the new home state of a nurse under pending investigation by the former home state shall be held in abeyance and the ninety day processing period shall be stayed until resolution of the pending investigation.
(Statutory basis:24 Del.C., Ch. 19A, Article 5[B])
184.108.40.206 The former home state license shall no longer be valid upon the issuance of a new home state license. (Statutory basis: 24 Del.C., Ch. 19A, Article 4D)
220.127.116.11 If a decision is made by the new home state denying licensure, the new home state shall notify the former home state within ten (10) business days and the former home state may take action in accordance with that state’s laws and rules.
Home state Boards shall include in all licensure disciplinary orders and/or agreements that limit practice and/ or require monitoring the requirement that the licensee subject to said order and/or agreement will agree to limit the licensee’s practice to the home state during the pendency of the disciplinary order and/or agreement. This requirement may, in the alternative, allow the nurse to practice in other party states with prior written authorization from both the home state and such other party state Boards. (Statutory basis: 24 Del.C. Ch. 1902A)
An individual who had a license which was surrendered, revoked, suspended, or an application denied for cause in a prior state of primary residence, may be issued a single state license in a new primary state of residence until such time as the individual would be eligible for an unrestricted license by the prior state(s) of adverse action. Once eligible for licensure in the prior state(s), a multistate license may be issued.
18.104.22.168 Non-party state Boards shall have access to all Information System data except current significant investigative information and other information as limited by contributing party state authority.
22.214.171.124 Party state Boards shall have access to all Information System data contributed by the party states and other information as limited by contributing non-party state authority. (Statutory basis: 24 Del.C. Ch. 19A, Article 7G)
14.4.2 The licensee may request in writing to the home state Board to review the data relating to the licensee in the Information System. In the event a licensee asserts that any data relating to him or her is inaccurate, the burden of proof shall be upon the licensee to provide evidence that substantiates such claim. The Board shall verify and within ten (10) business days correct inaccurate data to the Information System. (Statutory basis: 24 Del.C. Ch. 19A, Article 7G)
126.96.36.199 disciplinary action, agreement or order requiring participation in alternative programs or which limit practice or require monitoring (except agreements and orders relating to participation in alternative programs required to remain nonpublic by contributing state authority),
188.8.131.52 changes in status of disciplinary action, or licensure encumbrance. (Statutory basis: 24 Del.C. Ch. 19A, Article 7B)
14.4.4 Current significant investigative information shall be deleted from the Information System within ten(10) business days upon report of disciplinary action, agreement or order requiring participation in alternative programs or agreements which limit practice or require monitoring or dismissal of a complaint. (Statutory basis: 24 Del.C. Ch. 19A, Articles 7B, 7F)
The Board finds that for purposes of licensing, renewal, reinstatement and discipline, the conviction of any of the following crimes, or of the attempt to commit or a conspiracy to commit or conceal the following crimes or substantially similar crimes in another state or jurisdiction, is deemed to be substantially related to the practice of Nursing in the State of Delaware without regard to the place of conviction:
“Conviction” means a verdict of guilty by whether entered by a judge or jury, or a plea of guilty or a plea of nolo contendere or other similar plea such as a “Robinson” or “Alford” plea unless the individual has been discharged under §4218 of Title 11 of the Delaware Code (probation before judgment) or under §1024 of Title 10 (domestic violence diversion program) or by §4764 of Title 16 (first offenders controlled substances diversion program).
“Jurisdiction” means substantially similar crimes in another state or jurisdiction includes all crimes prohibited by or punishable under Title 18 of the United States Code Annotated (U.S.C.A.) such as, but not limited to, Federal Health Care offenses.
15.2 Any crime which involves the use of physical force or violence toward or upon the person of another and shall include by way of example and not of limitation the following crimes set forth in Title 11 of the Delaware Code Annotated:
15.2.42 §771 Rape in the third degree;
15.3 Any crime which involves dishonesty or false, fraudulent or aberrant behavior and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:
15.3.41 §903 A Re-encoder and scanning devices;
15.3.44 §907A Criminal impersonation, accident related;
15.5 Any crime which involves offenses against the public order the commission of which may tend to bring discredit upon the profession and which are thus substantially related to one’s fitness to practice such profession and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:
15.6 Any crime which involves offenses against a public health order and decency which may tend to bring discredit upon the profession, specifically including the below listed crimes from Title 11 of the Delaware Code Annotated which evidence a lack of appropriate concern for the safety and well being of another person or persons in general or sufficiently flawed judgment to call into question the individuals ability to make health care decisions or advise upon health care related matters for other individuals.
15.7 Any crime which involves the illegal possession or the misuse or abuse of narcotics, or other addictive substances and those non-addictive substances with a substantial capacity to impair reason or judgment and shall include by way of example and not of limitation the following crimes listed in Chapter 47 of Title 16 of the Delaware Code Annotated:
15.8 Any crime which involves the misuse or illegal possession or sale of a deadly weapon or dangerous instrument and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:
15.8.48 Title 21 §6705 Removed, falsified or unauthorized identification number on vehicle, bicycle or engine; removed or affixed license/registration plate with intent to misrepresent identify, Felony
15.8.52 §8715 felony fraud or distribution or attempted distribution of adulterated article.
15.8.53 §901 Offenses carrying penalty of imprisonment for 3 to 6 months – including peddling of alcoholic liquors, dispensing liquor from a disorderly house, selling alcoholic liquor without a license, claiming to have a license, keeping or selling for beverage purposes any solid or liquor containing alcohol not originally manufactured for use as a beverage
15.8.54 §903 Offenses carrying penalty of fine of not more than $100.00 or imprisonment for 1 month on failure to pay fine – including selling beer to which other alcohol has been added or selling adulterated alcoholic liquor; selling alcoholic liquor in time, manner or quantity not authorized by license; selling alcoholic beverage in dining room or bedroom not fitted equipped in manner prescribed by Commissioner/Division; selling alcoholic beverages without complying with specific provisions of statute; selling an alcoholic liquor at a time not authorized; selling alcoholic liquor to prohibited person; allowing alcoholic beverage to be consumed in liquor store; failing to post license conspicuously; keeping or transporting alcoholic liquor in contravention of the statute; selling a product containing alcoholic liquor as medicine after being notified by the Commissioner that a product is being used for beverage purposes; not having a license and inducing the public to believe person has license; buying or receiving alcoholic liquor from person not authorized to sell such liquor and keeping such liquor; obtaining during time when sale is forbidden any alcoholic liquor from a licensee for sale; causing a disturbance or bringing or drinking alcoholic liquor in a place where such is prohibited; buying alcoholic liquor from another person; being a licensee, failing to post conspicuously a sign warning against drinking during pregnancy
15.8.75 §2410 Breaking and Entering, Etc. to Place or Remove Equipment (class F felony)
15.8.86 §8562 Penalties [for failure of child-care provider to obtain information required under §8561 or for those providing false information] (class A misdemeanor, class G felony depending on the specifics of the offense]
15.8.92 §2513 Penalties [relating to improper health-care decisions] (misdemeanor, class felony for falsification, destruction of a document to create a false impression that measures to prolong life have been authorized)
15.8.97 §3913 Violations [knowing or reckless abuse of an infirm adult] (class A misdemeanor, class G felony for exploitation of infirm adult’s resources valued at $500 to $5000, class E felony if resources are valued from $5000 to $10,000, class D felony if resources are valued over $10,000 or if abuse or neglect results in bodily harm, class A felony if abuse or neglect results in death)
15.9.1 The license of any nurse convicted of a felony sexual offense will be automatically revoked. Applicants for licensure who have a conviction of a felony sexual offense are not eligible for licensure and a waiver will not be granted.
15.10 The Board reserves the jurisdiction and authority to modify this regulation as and if it becomes necessary to either add or delete crimes including such additions as may be required on an emergency basis under 29 Del.C. §10119 to address imminent peril to the public health, safety or welfare. The Board also specifically reserves the jurisdiction to review any crime committed by an applicant for licensure with regard to the temporal proximity of the crime or the conviction to the application and to determine whether the period of time involved has been so long as to negate any reasonable conclusion or determination that the crime for which the individual was convicted has a direct bearing on the individual’s fitness or ability to perform one or more of the duties and responsibilities necessarily related to nursing or to otherwise determine that sufficient restitution has been made for the offense committed.